Neoadjuvant durvalumab plus radiation versus durvalumab alone in stages I–III non-small cell lung cancer: survival outcomes and molecular correlates of a randomized phase II trial

杜瓦卢马布 医学 临床终点 肿瘤科 内科学 肺癌 随机对照试验 代理终结点 癌症 免疫疗法 无容量
作者
Nasser K. Altorki,Zachary Walsh,Johannes C. Melms,J. L. Port,Benjamin E. Lee,Abu Nasar,C Spinelli,Lindsay Caprio,Meri Rogava,Patricia Ho,Paul J. Christos,Ashish Saxena,Olivier Elemento,Bhavneet Bhinder,Casey R. Ager,Amit Dipak Amin,Nicholas J Sanfilippo,Vivek Mittal,Alain C. Borczuk,Silvia C. Formenti,Benjamin Izar,Timothy E. McGraw
出处
期刊:Nature Communications [Springer Nature]
卷期号:14 (1)
标识
DOI:10.1038/s41467-023-44195-x
摘要

Abstract We previously reported the results of a randomized phase II trial (NCT02904954) in patients with early-stage non-small cell lung cancer (NSCLC) who were treated with either two preoperative cycles of the anti-PD-L1 antibody durvalumab alone or combined with immunomodulatory doses of stereotactic radiation (DRT). The trial met its primary endpoint of major pathological response, which was significantly higher following DRT with no new safety signals. Here, we report on the prespecified secondary endpoint of disease-free survival (DFS) regardless of treatment assignment and the prespecified exploratory analysis of DFS in each arm of the trial. DFS at 2 and 3 years across patients in both arms of the trial were 73% (95% CI: 62.1–84.5) and 65% (95% CI: 52.5–76.9) respectively. For the exploratory endpoint of DFS in each arm of the trial, three-year DFS was 63% (95% CI: 46.0–80.4) in the durvalumab monotherapy arm compared to 67% (95% CI: 49.6–83.4) in the dual therapy arm. In addition, we report post hoc exploratory analysis of progression-free survival as well as molecular correlates of response and recurrence through high-plex immunophenotyping of sequentially collected peripheral blood and gene expression profiles from resected tumors in both treatment arms. Together, our results contribute to the evolving landscape of neoadjuvant treatment regimens for NSCLC and identify easily measurable potential biomarkers of response and recurrence.
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