PACIFIC Study Sets New Standard in Stage III NSCLC, Opens Door to Further Progress

The phase III PACIFIC trial, which investigated concurrent chemoradiation therapy and consolidative therapy with durvalumab (Imfinzi) in patients with unresectable stage III non–small cell lung cancer (NSCLC), not only set a definitive standard of care in this setting but also laid the groundwork for future immunotherapeutic developments, explained Scott J. Antonia, MD, PhD.

“This has become the new global standard of care, and it’s exciting because we've tried for decades to make an advance in this setting. Nothing that we've done over the past couple of decades has done [what this trial has for the space],” said Antonia. “This is the first treatment strategy that has improved the overall survival and changed the standard of care for these patients.”

In addition to boasting a 2-year overall survival (OS) rate of 66.3% (95% CI, 61.7%-70.4%) with the PD-L1 inhibitor durvalumab versus 55.6% (95% CI, 48.9-61.8) with placebo (two-sided P = .005), the trial set the stage to explore PD-1 and CTLA-4 inhibition in a similar fashion.