Subsequent treatment for locally advanced non-small-cell lung cancer that progressed after definitive chemoradiotherapy and consolidation therapy with durvalumab: a multicenter retrospective analysis (TOPGAN 2021-02)

Tsukasa Hasegawa; Ryo Ariyasu; Hisashi Tanaka; Ryota Saito; Yosuke Kawashima; Atsushi Horiike; Toshio Sakatani; Takehiro Tozuka; Jun Shiihara; Masafumi Saiki; Yuichi Tambo; Tomoaki Sonoda; Akito Miyazaki; Shinya Uematsu; Yuko Tsuchiya-Kawano; Noriko Yanagitani; Makoto Nishino

doi:10.1007/s00280-023-04547-2

Subsequent treatment for locally advanced non-small-cell lung cancer that progressed after definitive chemoradiotherapy and consolidation therapy with durvalumab: a multicenter retrospective analysis (TOPGAN 2021-02)

Cancer Chemother Pharmacol. 2023 Jul;92(1):29-37. doi: 10.1007/s00280-023-04547-2. Epub 2023 May 27.

Authors

Tsukasa Hasegawa¹, Ryo Ariyasu², Hisashi Tanaka³, Ryota Saito⁴, Yosuke Kawashima⁵, Atsushi Horiike⁶, Toshio Sakatani⁷, Takehiro Tozuka⁸, Jun Shiihara⁹, Masafumi Saiki¹⁰, Yuichi Tambo¹¹, Tomoaki Sonoda¹², Akito Miyazaki¹³, Shinya Uematsu¹⁴, Yuko Tsuchiya-Kawano¹⁵, Noriko Yanagitani¹⁶, Makoto Nishino¹⁶

Affiliations

¹ Division of Respiratory Disease, Department of Internal Medicine, The Jikei University Daisan Hospital, Tokyo, Japan.
² Department of Thoracic Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan. ryo.ariyasu@jfcr.or.jp.
³ Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
⁴ Department of Respiratory Medicine, Tohoku University Hospital, Sendai, Japan.
⁵ Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan.
⁶ Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
⁷ Division of Respiratory, NTT Medical Center, Tokyo, Japan.
⁸ Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
⁹ Department of Pulmonary Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
¹⁰ Department of Respiratory Medicine, Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan.
¹¹ Department of Respiratory Medicine, Kanazawa University, Kanazawa, Japan.
¹² Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
¹³ Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Osaka, Japan.
¹⁴ Department of Respiratory Medicine, Osaka Red Cross Hospital, Osaka, Japan.
¹⁵ Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
¹⁶ Department of Thoracic Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.

PMID: 37243795
DOI: 10.1007/s00280-023-04547-2

Abstract

Purpose: For patients with locally advanced non-small-cell lung cancer (LA-NSCLC) that progressed after definitive chemoradiotherapy (CRT) and durvalumab consolidation therapy, no subsequent standard treatment exists. The type of treatment selected for each timing of disease progression and its efficacy have not been investigated.

Methods: We retrospectively enrolled patients with LA-NSCLC or inoperable NSCLC that progressed after definitive CRT and durvalumab consolidation therapy at 15 Japanese institutions. Patients were classified into the following: Early Discontinuation group (disease progression within 6 months after durvalumab initiation), Late Discontinuation group (disease progression from 7 to 12 months after durvalumab initiation), and Accomplishment group (disease progression from 12 months after durvalumab initiation).

Results: Altogether, 127 patients were analyzed, including 50 (39.4%), 42 (33.1%) and 35 (27.5%) patients from the Early Discontinuation, Late Discontinuation, and Accomplishment groups, respectively. Subsequent treatments were Platinum plus immune checkpoint inhibitors (ICI) in 18 (14.2%), ICI in 7 (5.5%), Platinum in 59 (46.4%), Non-Platinum in 35 (27.6%), and tyrosine kinase inhibitor in 8 (6.3%) patients. In the Early Discontinuation, Late Discontinuation, and Accomplishment groups, 4 (8.0%), 7 (16.7%), and 7 (20.0%) patients were receiving Platinum plus ICI; 21 (42.0%), 22 (52.4%), and 16 (45.7%) were receiving Platinum, and 20 (40.0%), 8 (19.0%), and 7 (20.0%) were receiving Non-Platinum, respectively. No significant difference in progression-free survival was observed in the timing of disease progression.

Conclusion: In patients with LA-NSCLC hat progressed after definitive CRT and durvalumab consolidation therapy, subsequent treatment may change depending on the timing of disease progression.

Keywords: Chemoradiotherapy; Durvalumab; Stage III non-small-cell lung cancer; Subsequent treatment.

Publication types

Multicenter Study

MeSH terms

Antineoplastic Agents, Immunological*
Carcinoma, Non-Small-Cell Lung* / drug therapy
Chemoradiotherapy
Consolidation Chemotherapy
Disease Progression
Humans
Lung Neoplasms* / drug therapy
Neoplasm Staging
Retrospective Studies

Substances

durvalumab
Antineoplastic Agents, Immunological