Safety and efficacy of durvalumab after concurrent chemoradiation in Black patients with locally advanced non–small cell lung cancer

Abstract

AbstractBackgroundThe PACIFIC trial established consolidative durvalumab after concurrent chemoradiation as standard‐of‐care in patients with stage III or unresectable non–small cell lung cancer (NSCLC). Black patients, however, comprised just 2% (n = 14) of randomized patients in this trial, warranting real‐world evaluation of the PACIFIC regimen in these patients.MethodsThis single‐institution, multi‐site study included 105 patients with unresectable stage II/III NSCLC treated with concurrent chemoradiation followed by durvalumab between 2017 and 2021. Overall survival (OS), progression‐free survival (PFS), and grade ≥3 pneumonitis‐free survival (PNFS) were compared between Black and non‐Black patients using Kaplan–Meier and Cox regression analyses.ResultsA total of 105 patients with a median follow‐up of 22.8 months (interquartile range, 11.3–37.3 months) were identified for analysis, including 57 Black (54.3%) and 48 (45.7%) non‐Black patients. The mean radiation prescription dose was higher among Black patients (61.5 ± 2.9 Gy vs. 60.5 ± 1.9 Gy; p = .031), but other treatment characteristics were balanced between groups. The median OS (not‐reached vs. 39.7 months; p = .379) and PFS (31.6 months vs. 19.3 months; p = .332) were not statistically different between groups. Eight (14.0%) Black patients discontinued durvalumab due to toxicity compared to 13 (27.1%) non‐Black patients (p = .096). The grade ≥3 pneumonitis rate was similar between Black and non‐Black patients (12.3% vs. 12.5%; p = .973), and there was no significant difference in time to grade ≥3 PNFS (p = .904). Three (5.3%) Black patients and one (2.1%) non‐Black patient developed grade 5 pneumonitis.ConclusionsThe efficacy and tolerability of consolidative durvalumab after chemoradiation appears to be comparable between Black and non‐Black patients.