AI Article Synopsis
- In a study of 328 patients with stage III non-small cell lung cancer (NSCLC) undergoing concurrent chemoradiation and durvalumab treatment, high PD-L1 expression (≥90%) and elevated tumor mutational burden (TMB) were found to enhance disease control.
- The timing of pneumonitis onset significantly affected patient outcomes; those with late-onset pneumonitis had longer progression-free survival (PFS) and overall survival compared to those with early-onset pneumonitis.
- The research indicates potential strategies to improve treatment outcomes for patients with lower PD-L1 and TMB levels, especially those at risk for pneumonitis.
Article Abstract
Although concurrent chemoradiation (CRT) and durvalumab consolidation has become a standard treatment for stage III non-small cell lung cancer (NSCLC), clinicopathologic and genomic factors associated with its efficacy remain poorly characterized. Here, in a multi-institutional retrospective cohort study of 328 patients treated with CRT and durvalumab, we identify that very high PD-L1 tumor proportion score (TPS) expression ( ≥ 90%) and increased tumor mutational burden (TMB) are independently associated with prolonged disease control. Additionally, we identify the impact of pneumonitis and its timing on disease outcomes among patients who discontinue durvalumab: compared to patients who experienced early-onset pneumonitis ( < 3 months) leading to durvalumab discontinuation, patients with late-onset pneumonitis had a significantly longer PFS (12.7 months vs not reached; HR 0.24 [95% CI, 0.10 to 0.58]; P = 0.001) and overall survival (37.2 months vs not reached; HR 0.26 [95% CI, 0.09 to 0.79]; P = 0.017). These findings suggest that opportunities exist to improve outcomes in patients with lower PD-L1 and TMB levels, and those at highest risk for pneumonitis.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349822 | PMC |
| http://dx.doi.org/10.1038/s41467-023-39874-8 | DOI Listing |
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