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PACIFIC Trial Changes Standard of Care in Stage III NSCLC

Brandon Scalea
Published: Tuesday, Dec 11, 2018

Adham Jurdi, MD

Adham Jurdi, MD

The PACIFIC trial proves that immunotherapy has an essential role in stage III non–small cell lung cancer (NSCLC); however, there are still unanswered questions surrounding the optimal sequence of checkpoint inhibitors and whether it is appropriate for patients with driver mutations, said Adham Jurdi, MD.

In the phase III study, consolidation immunotherapy with durvalumab (Imfinzi) significantly improved progression- free survival (PFS) and overall survival (OS) versus placebo in patients with stage III NSCLC who did not have disease progression after 2 or more cycles of platinum-based chemoradiation. Two-year OS rates in the durvalumab group were 66.3% compared with 55.6% for patients who were treated with placebo, according to updated data published in the New England Journal of Medicine.

Updated analyses regarding PFS were similar to those previously reported, with a median duration of 17.2 months observed in the durvalumab arm and 5.6 months in the placebo arm. Median time to death or distant metastasis was 28.3 months for patients treated with the PD-1 inhibitor versus 16.2 months for those who received placebo. For the trial, 713 patients were randomly assigned 2:1 to receive durvalumab intravenously, at a dose of 10 mg/kg, or matching placebo every 2 weeks for up to 12 months. Randomization occurred 1 to 42 days after the patients had received chemoradiotherapy.

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