Real-world 5-year outcomes with durvalumab after chemoradiotherapy in unresectable stage III NSCLC

Girard N, Bar J, Baas P, Chouaid C, Christoph DC, Field JK, Fietkau R, Garassino MC, Garrido Lopez P, Gregorc V, Haakensen VD, Hiltermann TJ, Kao S, McDonald F, Mornex F, Moskovitz M, Peters S, Siva S, Solomon B, Qiao Y, Anand S, Chander P, Shcherbakova T, Diaz Perez I, Filippi AR (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Book Volume: 11

Article Number: 106070

Journal Issue: 2

DOI: 10.1016/j.esmoop.2026.106070

Abstract

Background: Consolidation durvalumab is standard of care treatment for patients with unresectable, stage III non-small-cell lung cancer without progression after chemoradiotherapy. Additional study is warranted to investigate the long-term efficacy of this regimen in real-world settings. Methods: PACIFIC-R (NCT03798535) was an international, observational, cohort study of patients who started durvalumab 10 mg/kg intravenously every 2 weeks within an AstraZeneca-initiated early access program between September 2017 and December 2018. Data were extracted retrospectively from medical records to describe the real-world effectiveness of consolidation durvalumab in patients with unresectable non-small-cell lung cancer without progression after chemoradiotherapy. The primary endpoints were real-world progression-free survival (rwPFS) and overall survival (OS). Results: Median age was 65.0 years (range 26-88 years); most patients [747/1153 (64.8%)] were male and current [300/1153 (26.0%)] or former [750/1153 (65.0%)] smokers. Among patients with reported data, most had Eastern Cooperative Oncology Group performance status <2 [743/755 (98.4%)], stage IIIB/C disease [584/1090 (53.6%)], non-squamous histology [746/1137 (65.6%)], and programmed death-ligand 1 expression on ≥1% of tumor cells [572/791 (72.3%)]. Median follow-up (censored patients) was 63.5 months for rwPFS and 67.5 months for OS. Median rwPFS was 24.3 months [95% confidence interval (CI) 20.3-28.4 months]; 5-year rwPFS was 35.2% (95% CI 32.4% to 38.1%). Median OS was 59.0 months (95% CI 52.7-64.3 months); 5-year OS was 49.2% (95% CI 46.2% to 52.2%). Encouraging results were observed across subgroups, including among patients who received durvalumab after either concurrent or sequential chemoradiotherapy [median rwPFS (95% CI): 25.8 months (20.9-31.8 months) versus 23.2 months (16.9-29.5 months); median OS: 63.1 months (57.3-73.5 months) versus 47.1 months (35.3-58.1 months)], and irrespective of programmed death-ligand 1 expression [on ≥1% versus <1% of tumor cells; median rwPFS (95% CI): 25.5 months (19.1-32.8 months) versus 16.3 months (10.9-27.5 months); median OS: 62.4 months (55.0 months-not estimable) versus 43.3 months (31.6-60.7) months]. Conclusions: PACIFIC-R provides mature data on OS and rwPFS from a large, real-world cohort, supporting consolidation durvalumab as a standard of care in this setting.

Authors with CRIS profile

Involved external institutions

Institut Curie France (FR) Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Israel (IL) Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI / NKI-AVL) Netherlands (NL) Hôpital Intercommunal de Créteil (CHIC) France (FR) Evangelisches Krankenhaus Herne Germany (DE) The University of Liverpool United Kingdom (GB) University of Chicago United States (USA) (US) Hospital Universitario Ramón y Cajal Spain (ES) Candiolo Cancer Institute - IRCCS Italy (IT) Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet Norway (NO) University Medical Center Groningen (UMCG) / Universitair Medisch Centrum Groningen Netherlands (NL) Chris O’Brien Lifehouse Australia (AU) Royal Marsden Hospital / The Royal Marsden NHS Foundation Trust United Kingdom (GB) Hospices Civils de Lyon (CHU) France (FR) Rambam Health Care Campus Israel (IL) Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV) Switzerland (CH) Peter MacCallum Cancer Centre Australia (AU) University of Cambridge United Kingdom (GB) Università degli Studi di Pavia Italy (IT)

How to cite

APA:

Girard, N., Bar, J., Baas, P., Chouaid, C., Christoph, D.C., Field, J.K.,... Filippi, A.R. (2026). Real-world 5-year outcomes with durvalumab after chemoradiotherapy in unresectable stage III NSCLC. ESMO Open, 11(2). https://doi.org/10.1016/j.esmoop.2026.106070

MLA:

Girard, N., et al. "Real-world 5-year outcomes with durvalumab after chemoradiotherapy in unresectable stage III NSCLC." ESMO Open 11.2 (2026).

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