Dr. Garon on Immunotherapy in Stage III Unresectable NSCLC

Edward B. Garon, MD, director of Thoracic Oncology at the Jonsson Comprehensive Cancer Center at University of California, Los Angeles, discusses the promise of immunotherapy in the treatment of patients with stage III unresectable non—small cell lung cancer.

Only the phase III PACIFIC trial has looked at this, Garon says, but it has led to 2 New England Journal of Medicine articles delving into progression-free (PFS) and overall survival (OS) findings. PACIFIC evaluated durvalumab (Imfinzi) versus placebo following concurrent chemoradiation in these patients, showing an improvement in both PFS and OS with the addition of the PD-1 inhibitor. Updated analyses show that median PFS in the durvalumab arm was 17.2 months compared with 5.6 months with placebo. In addition, 2-year OS rates were 66.3% to 55.6% in favor of durvalumab.

Most surprisingly, Garon says, the regimen appeared to be well tolerated. There was significant concern with pneumonitis, which can be a serious adverse event of both immunotherapy and radiation therapy, but there was no added severity in that area.