Dr. Fujioka on Remaining Questions After the PACIFIC Trial in NSCLC

Naomi Fujioka, MD, assistant professor of medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, discusses the questions that remain after the PACIFIC trial in stage III non—small cell lung cancer (NSCLC).

The PACIFIC trial was a phase III randomized trial that looked at patients who received standard chemoradiation at standard doses and were randomized to receive durvalumab (Imfinzi) or placebo for 1 year. In the durvalumab arm, overall survival was improved compared with placebo. Patients tolerated treatment well and there were no unexpected safety signals.

What remains to be seen is what type of treatment should be given post-chemoradiation for different patient subsets of patients, explains Fujioka. Any kind of treatment after chemoradiation applies to many different subsets of patients. For example, patients with EGFR mutations traditionally do not respond as well to immunotherapy alone in the metastatic setting. Fujioka says there are many different nuances that apply to stage III NSCLC that need to be addressed, such as how to treat patients with bulky N2 or N3 disease. The PACIFIC trial examined a heterogenous population; therefore, the data must now be refined, concludes Fujioka.