Dr. Borghaei Discusses the PACIFIC Trial in Lung Cancer

Author(s):

Hossein Borghaei, DO, chief, Division of Thoracic Medical Oncology, director, Lung Cancer Risk Assessment, associate professor, Department of Hematology/Oncology, Fox Chase Cancer Center, discusses the PACIFIC trial in patients with non–small cell lung cancer (NSCLC).

The PACIFIC study was conducted in patients with locally advanced, stage III unresectable NSCLC regardless of histology. Patients had completed a course of chemotherapy and radiation, and were randomized to receive durvalumab (Imfinzi) or observation. Patients in the durvalumab group had a significantly better progression-free survival (PFS) compared to the control arm, says Borghaei.

The trial demonstrated median PFS for durvalumab of 16.8 months (95% CI, 13.0-18.1) versus 5.6 months (95% CI, 4.6-7.8) for placebo. The 12-month PFS rate was 55.9% for durvalumab (95% CI, 51.0-60.4) and 35.3% (95% CI, 29.0-41.7), for placebo; and the 18-month PFS rate was 44.2% (95% CI, 37.7-50.5) and 27% (95% CI, 19.9-34.5), respectively.

There were no overall survival (OS) data published, which was another endpoint of the study, but PFS was significantly better by 11 months. Borghaei says that the interesting part was that treatment with durvalumab did not lead to a significant increase in toxicities. Most physicians were expecting to see higher rates of pneumonitis but this was not seen. According to Borghaei, the lack of OS data is the only hesitation physicians have about durvalumab in this patient population.