Dr. Langer on Practice-Changing PACIFIC Data in Stage III NSCLC

Corey J. Langer, MD, director, Thoracic Oncology, Abramson Cancer Center, professor of medicine, Perelman School of Medicine, University of Pennsylvania, discusses the practice-changing data from the PACIFIC trial, which evaluated durvalumab (Imfinzi) for the treatment of patients with locally advanced, unresectable stage III non—small cell lung cancer (NSCLC) who have not progressed following chemoradiotherapy.

The stage III NSCLC landscape has evolved over the last 1.5 years, said Langer. The standard, he says, until 2017 was standard concurrent radiation. Research efforts to improve outcomes included either increasing radiation dose, adding chemotherapy after chemoradiation, and introducing other targeted agents such as cetuximab (Erbitux) failed and showed no survival increment.

The therapeutic landscape has completely transformed with the game-changing results of the PACIFIC trial, said Langer. The phase III study specifically evaluated the role of durvalumab following standard chemoradiation versus placebo following chemoradiation in a 2:1 randomization showing an absolutely unprecedented improvement in progression-free survival (PFS). Median PFS was short of 5.6 months compared with 16.8 months in the durvalumab arm. There was also no significant increase in toxicity, said Langer, aside from rates of pneumonitis that were manageable. There was also a reduction in the incidence of metastases, he concludes.

The FDA approved durvalumab for the treatment of patients with locally advanced, unresectable stage III NSCLC who have not progressed following chemoradiotherapy in February 2018.

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