Dr. Garassino on the Rationale for the PACIFIC-6 Trial in NSCLC

Marina Chiara Garassino, MD, professor of medicine, Department of Medicine, Section of Hematology/Oncology, Knapp Center for Biomedical Discovery, The University of Chicago, discusses the rationale for the phase 2 PACIFIC-6 trial (NCT03693300) in non–small cell lung cancer (NSCLC).

Findings from the phase 3 PACIFIC trial demonstrated a significant improvement in progression-free survival and overall survival with 1 year of durvalumab (Imfinzi) vs placebo in patients with stage III, unresectable NSCLC whose disease had not progressed following platinum-based, concurrent chemoradiation. Based on findings from the study, the FDA approved durvalumab in 2018 for the treatment of patients with locally advanced, unresectable, stage III NSCLC who have not progressed following chemoradiotherapy. On November 20, 2020, an additional dosing option of durvalumab—a fixed dose of 1500 mg every 4 weeks— was approved by the FDA for use in the approved indication of unresectable stage III NSCLC after chemoradiation.

Despite these findings, many patients with unresectable NSCLC are ineligible for concurrent chemoradiotherapy, says Garassino. As such, the PACIFIC-6 trial is evaluating the safety and efficacy of 2 years of durvalumab after sequential chemotherapy and radiation therapy in this patient population, concludes Garassino.