%0 Journal Article
%T Durvalumab consolidation in patients with unresectable stage III non-small cell lung cancer with driver genomic alterations.
%A Riudavets M
%A Auclin E
%A Mosteiro M
%A Dempsey N
%A Majem M
%A Lobefaro R
%A López-Castro R
%A Bosch-Barrera J
%A Pilotto S
%A Escalera E
%A Tagliamento M
%A Mosquera J
%A Zalcman G
%A Aboubakar-Nana F
%A Ponce S
%A Dal Maso A
%A Spotti M
%A Mielgo-Rubio X
%A Mussat E
%A Reyes R
%A Benítez JC
%A Lupinacci L
%A Duchemann B
%A De Giglio A
%A Blaquier J
%A Audigier-Valette C
%A Scheffler M
%A Nadal E
%A Lopes G
%A Signorelli D
%A Garcia-Campelo R
%A Menis J
%A Bluthgen V
%A Campayo M
%A Recondo G
%A Besse B
%A Planchard D
%A Mezquita L
%J Eur J Cancer
%V 167
%N 0
%D 05 2022
%M 35307254
%F 10.002
%R 10.1016/j.ejca.2022.02.014
%X Durvalumab is the standard-of-care as consolidation therapy after chemo-radiotherapy in stage III unresectable non-small cell lung cancer (NSCLC); however, its activity across patients with NSCLC harbouring driver genomic alterations (dGA) is poorly characterised.<BR>Multicentre retrospective study including patients with stage III unresectable NSCLC treated with durvalumab after chemo-radiotherapy between April 2015 and October 2020 at 26 centres in Europe and America. Clinical and biological data were collected; dGA included: EGFR/BRAF/KRAS mutations (m) and ALK/ROS1 rearrangements (r). We evaluated progression-free survival (PFS) and overall survival (OS) based on dGA.<BR>Out of 323 patients included, 43 patients had one dGA: KRASm (n = 26; 8 G12C), EGFRm (n = 8; 6 del19/ex21), BRAFm (n = 5; 4 V600E) and ALKr (n = 4). The median age was 66 years [39-84], gender ratio 1:1, with 98% performance status (PS) 0-1 and 19% non-smokers; 88% had adenocarcinoma. PD-L1 was positive in 85% (n = 4 missing). In the whole cohort, the median PFS was 17.5 months (mo.) (95% CI, 13.2-24.9) and median OS 47 mo (95%CI, 47-not reached [NR]). No statistically significant differences in terms of the median PFS were observed between patients with dGA vs. non-dGA: 14.9 mo (95% CI, 8.1-NR) vs. 18 mo. (95% CI, 13.4-28.3) (P = 1.0); however, when analysed separately: the median PFS was NR (11.3-NR) in the KRASm G12C vs. 8.1 mo (5.8-NR) in the EGFRm del19/ex21 vs. 7.8 mo (7.7-NR) in the BRAFm V600E/ALKr (P = 0.02).<BR>We observed limited activity of durvalumab consolidation in patients with stage III unresectable NSCLC with EGFR/BRAFm and ALKr but not for those harbouring KRASm. Larger prospective studies are needed to confirm these findings.