In the randomised, double-blind phase III trial PACIFIC, durvalumab has shown to improve progression-free survival (PFS) while upholding quality of life measures in locally advanced, unresectable non-small cell lung cancer (NSCLC) patients (abstract PL 02.02). Dr. Rina Hui of the University of Sydney and Westmead Hospital in Australia presented these findings on Tuesday at the IASLC 18th WCLC in Yokohama.
Assessment of QoL
The researchers viewed patient-reported quality of life data as imperative to better informing the decision of whether or not to administer durvalumab in this patient population. The researchers randomized NSCLC patients who had received standard concurrent chemoradiation, but had not experienced disease progression, into two groups. The intervention group was treated with durvalumab for up to twelve months, while the control group was treated with placebo. Symptoms, function and global health status/QoL were evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 v3 questionnaire and its lung cancer module, QLQ-LC13. Patients completed the questionnaires at baseline, Week 4, Week 8, q8w until Week 48, then q12w until disease progression. Changes from baseline for key symptoms were analysed using a mixed model for repeated measures (MMRM). Time to deterioration (TTD) and odds of improvement were analysed. Deterioration or improvement was defined as a change in score from baseline ≥ 10. Hazard ratios (HR) were calculated using a stratified log-rank test and odds ratios (OR) using logistic regression.
The results of the study showed that patients treated with durvalumab did not experience worsening of symptoms, function or health-related quality of life, which was similar to patients who received placebo. These results strongly support the use of durvalumab in this disease setting, as the health benefits are significant and the treatment option is tolerable. Additionally, these outcomes may prompt consideration of this intervention as a new standard of care among this population.
“As a clinician, this study is important because up until now, the 5-year survival rate of patients with locally advanced NSCLC is only 15 %”, said Dr. Hui. “This study offers hope for improved patient outcomes without compromising quality of life by the treatment.”
Hui R et al., abstract PL 02.02: Patient-Reported Outcomes with Durvalumab after Chemoradiation in Locally Advanced, Unresectable NSCLC: Data from PACIFIC