Non-Small Cell Lung Cancer · Medical Oncology
PACIFIC
After definitive concurrent chemoradiotherapy for unresectable stage III NSCLC, does consolidation durvalumab improve survival?
Population
713 patients with unresectable stage III NSCLC without progression after concurrent CRT
5-year OS
42.9% vs 33.4%
Absolute improvement 9.5 percentage points; NNT 11
5-year PFS
33.1% vs 19.0%
Absolute improvement 14.1 percentage points
Treatment discontinuation from AEs
15.4% vs 9.8%
Absolute increase 5.6 points; NNH 18
Absolute Effect
NNT: 11, based on 5-year overall survival. One additional patient was alive at five years for approximately every 11 patients treated with consolidation durvalumab.
NNH: 18, based on treatment discontinuation because of adverse events. Grade 3–4 adverse events were 30.5% versus 26.1%.
Clinical interpretation
PACIFIC established consolidation durvalumab as a survival-improving strategy after successful definitive CRT in unresectable stage III NSCLC. Its 9.5-point absolute five-year survival gain provides an important benchmark when evaluating later radiation–immunotherapy strategies.
Primary source
Spigel DR, et al. J Clin Oncol. 2022;40:1301–1311.