Ćeriman Krstić Vesna, Samardžić Natalija, Popević Spasoje, Stević Ruža, Ilić Branislav, Gajić Milija, Čolić Nikola, Lukić Katarina, Milošević Maračić Brankica, Poparić Banđur Bojana, Šeha Biljana, Radončić Damir, Milin Lazović Jelena
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Clinic for Pulmonology, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Biomedicines. 2025 Apr 7;13(4):892. doi: 10.3390/biomedicines13040892.
Patients with stage III non-small cell lung cancer represent a very heterogeneous group of patients. In the past, the standard of care for patients with inoperable stage III non-small cell lung cancer was concurrent or sequential radical radiotherapy and chemotherapy. But the progression-free survival was 8 months, and the 5-year overall survival rate was less than 20%. After the results of the PACIFIC study, the standard of care for this group of patients is chemoradiotherapy with durvalumab as consolidation therapy. The aim of our study was to evaluate the efficacy of consolidation durvalumab in a real-world setting after sequential CRT. We included 24 patients with unresectable stage III non-small cell lung cancer who did not progress after sequential chemoradiotherapy and who received durvalumab consolidation. Median progression-free survival was 16 months, 95% CI (0.5-31.5), and median overall survival was 20 months, 95% CI (13.4-26.6 months). The twelve-month progression-free survival and overall survival rate were 55.1% and 68%, respectively, and the 18-month progression-free survival and overall survival rates were 44.1% and 56.5%, respectively. Durvalumab introduced a new era in the treatment of patients with unresectable stage III non-small cell lung cancer with a significantly prolonged 5-year overall survival rate. Our study is one of the few that investigated the efficacy of durvalumab in a real-world setting after sequential CRT. Our results showed that durvalumab is effective in patients who were treated with sequential CRT. However, the time between radiotherapy termination and the start of durvalumab should be shorter.
III期非小细胞肺癌患者是一个非常异质性的患者群体。过去，无法手术的III期非小细胞肺癌患者的标准治疗方案是同步或序贯根治性放疗和化疗。但无进展生存期为8个月，5年总生存率低于20%。在PACIFIC研究结果公布后，该组患者的标准治疗方案是采用度伐利尤单抗进行巩固治疗的放化疗。我们研究的目的是评估序贯放化疗后在真实世界中使用度伐利尤单抗进行巩固治疗的疗效。我们纳入了24例无法切除的III期非小细胞肺癌患者，这些患者在序贯放化疗后未进展且接受了度伐利尤单抗巩固治疗。中位无进展生存期为16个月，95%置信区间（0.5 - 31.5），中位总生存期为20个月，95%置信区间（13.4 - 26.6个月）。12个月的无进展生存率和总生存率分别为55.1%和68%，18个月的无进展生存率和总生存率分别为44.1%和56.5%。度伐利尤单抗开创了无法切除的III期非小细胞肺癌患者治疗的新时代，5年总生存率显著延长。我们的研究是少数几项调查序贯放化疗后在真实世界中使用度伐利尤单抗疗效的研究之一。我们的结果表明，度伐利尤单抗对接受序贯放化疗的患者有效。然而，放疗结束至开始使用度伐利尤单抗的时间应更短。
