{Reference Type}: Journal Article
{Title}: Durvalumab consolidation in patients with unresectable stage III non-small cell lung cancer with driver genomic alterations.
{Author}: Riudavets M;Auclin E;Mosteiro M;Dempsey N;Majem M;Lobefaro R;López-Castro R;Bosch-Barrera J;Pilotto S;Escalera E;Tagliamento M;Mosquera J;Zalcman G;Aboubakar-Nana F;Ponce S;Dal Maso A;Spotti M;Mielgo-Rubio X;Mussat E;Reyes R;Benítez JC;Lupinacci L;Duchemann B;De Giglio A;Blaquier J;Audigier-Valette C;Scheffler M;Nadal E;Lopes G;Signorelli D;Garcia-Campelo R;Menis J;Bluthgen V;Campayo M;Recondo G;Besse B;Planchard D;Mezquita L;
{Journal}: Eur J Cancer
{Volume}: 167
{Issue}: 0
{Year}: 05 2022
{Factor}: 10.002
{DOI}: 10.1016/j.ejca.2022.02.014
{Abstract}: 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.