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@ARTICLE{Taugner:167866,
author = {J. Taugner and L. Käsmann$^*$ and C. Eze and A. Rühle$^*$
and A. Tufman and N. Reinmuth and T. Duell and C. Belka$^*$
and F. Manapov$^*$},
title = {{R}eal-world prospective analysis of treatment patterns in
durvalumab maintenance after chemoradiotherapy in
unresectable, locally advanced {NSCLC} patients.},
journal = {Investigational new drugs},
volume = {39},
number = {4},
issn = {1573-0646},
address = {Dordrecht [u.a.]},
publisher = {Springer Science + Business Media B.V},
reportid = {DKFZ-2021-00600},
pages = {1189-1196},
year = {2021},
note = {2021 Aug;39(4):1189-1196},
abstract = {The aim of this prospective study is to evaluate the
clinical use and real-world efficacy of durvalumab
maintenance treatment after chemoradiotherapy (CRT) in
unresectable stage, locally advanced non-small cell lung
cancer (NSCLC). All consecutive patients with unresectable,
locally advanced NSCLC and PD-L1 expression $(≥1\%)$
treated after October 2018 were included. Regular follow up,
including physical examination, PET/CT and/or
contrast-enhanced CT-Thorax/Abdomen were performed every
three months after CRT. Descriptive treatment pattern
analyses, including reasons of discontinuation and salvage
treatment, were undertaken. Statistics were calculated from
the last day of thoracic irradiation (TRT). Twenty-six
patients were included. Median follow up achieved
20.6 months (range: 1.9-30.6). Durvalumab was initiated
after a median of 25 (range: 13-103) days after completion
of CRT. In median 14 (range: 2-24) cycles of durvalumab were
applied within 6.4 (range 1-12.7) months. Six patients
$(23\%)$ are still in treatment and seven $(27\%)$ have
completed treatment with 24 cycles. Maintenance treatment
was discontinued in 13 $(50\%)$ patients: 4 $(15\%)$
patients developed grade 3 pneumonitis according to CTCAE v5
after a median of 3.9 (range: 0.5-11.6) months and 7 (range:
2-17) cycles of durvalumab. Four $(15\%)$ patients developed
grade 2 skin toxicity. One $(4\%)$ patient has discontinued
treatment due to incompliance. Six and 12- month
progression-free survival (PFS) rates were $82\%$ and
$62\%,$ median PFS was not reached. No case of
hyperprogression was documented. Eight $(31\%)$ patients
have relapsed during maintenance treatment after a median of
4.8 (range: 2.2-11.3) months and 11 (range: 6-17) durvalumab
cycles. Two patients $(9\%)$ developed a local-regional
recurrence after 14 and 17 cycles of durvalumab.
Extracranial distant metastases and brain metastases as
first site of failure were detected in 4 $(15\%)$ and 2
$(8\%)$ patients, respectively. Three $(13\%)$ patients
presented with symptomatic relapse. Our prospective study
confirmed a favourable safety profile of durvalumab
maintenance treatment after completion of CRT in
unresectable stage, locally advanced NSCLC in a real-world
setting. In a median follow-up time of 20.6 months,
durvalumab was discontinued in $27\%$ of all patients due to
progressive disease. All patients with progressive disease
were eligible for second-line treatment.},
keywords = {Checkpoint inhibition (Other) / Chemoradiotherapy (Other) /
Non-small cell lung cancer (Other) / PD-L1 inhibitor (Other)
/ Treatment pattern (Other)},
cin = {MU01 / FR01 / E055},
ddc = {610},
cid = {I:(DE-He78)MU01-20160331 / I:(DE-He78)FR01-20160331 /
I:(DE-He78)E055-20160331},
pnm = {315 - Bildgebung und Radioonkologie (POF4-315)},
pid = {G:(DE-HGF)POF4-315},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:33704621},
doi = {10.1007/s10637-021-01091-9},
url = {https://inrepo02.dkfz.de/record/167866},
}