Dr. Subramanian on the Current Standard of Care in Stage III NSCLC

Janakiraman Subramanian, MD, medical oncologist, director of Thoracic Oncology, Center for Precision Medicine, Saint Luke’s Cancer Institute, discusses the standard of care in stage III non–small cell lung cancer (NSCLC). 

The standard of care for stage III unresectable NSCLC has remained chemoradiation; however, in recent years, immunotherapy has been incorporated to ​further target cancer in this patient population, Subramanian explains. Moreover, durvalumab (Imfinzi) was FDA approved in February 2018 for the treatment of patients with unresectable stage III NSCLC whose disease has not progressed following concurrent platinum-based chemoradiation. The regulatory decision was based on data from the phase 3 PACIFIC trial (NCT02125461),which led to the field adopting durvalumab as the standard of care for this patient population, Subramanian says.

Patients receive up-front chemoradiation. Then, depending on their disease stability, they receive consolidative durvalumab, Subramanian continues. The 5-year survival update of the PACIFIC trial showed that the addition of durvalumab significantlyimproved long-term survival for these patients, Subramanian concludes.