Success of Durvalumab Immunotherapy in Stage 3 Lung Cancer Treatment

For inoperable stage 3 disease, non-small cell lung cancer treatment is an area in which we have faced difficulties and sought new approaches for years. In this patient group, the standard treatment is radiotherapy with concurrent chemotherapy. Despite combining our two most important treatment methods, only %15 of patients live five years or longer.

In recent years, immunotherapies have proven effective in many cancer types, including advanced (metastatic) lung cancer. ESMO 2017 , the European Oncology Congress, also tested immunotherapies in patients with different cancer types at earlier stages. PACIFIC was the name of a study in patients with inoperable stage 3 non-small cell lung cancer whose disease was controlled after chemotherapy given concurrently with radiotherapy; they received the immunotherapy drug durvalumab (Imfinzi) for 1 year.

The immunotherapy drug durvalumab blocks a protein called PDL-1, which causes our defense cells to be blind to cancer, helping them recognize and destroy cancer cells.

The phase 3 randomized study PACIFIC was conducted across 26 countries and 235 cancer centers. It enrolled 713 patients with stage 3 non-small cell lung cancer in a 2 to 1 ratio. All patients received concurrent radiotherapy and chemotherapy; 2/3 then received durvalumab after chemoradiotherapy at 10 mg/kg every two weeks for 12 months, while the other group received placebo.

Median time to disease progression was 16.8 months in patients receiving immunotherapy, compared with 5.6 months in the group receiving chemoradiotherapy alone.

Durvalumab was found to reduce lung cancer progression by %48. Although treatment side effects were higher in patients receiving durvalumab, they were considered manageable.

The PACIFIC study, which produced preliminary results strong enough to change treatment strategy, yielded promising findings in stage 3 non-small cell lung cancer treatment for the first time in many years. We hope survival outcomes will support these successful preliminary findings and lead to a new treatment from which our patients benefit more in this area.

We await the results of the long-term survival comparison and will share them with you.