Concurrent/sequential versus sequential immune checkpoint inhibition in inoperable large stage III non-small cell lung cancer patients treated with chemoradiotherapy: a prospective observational study

• DOI: 10.1007/s00432-023-04654-w
• Publication Date: 2023-03-20T16:03:01Z
• Authors: Lukas Käsmann; Chukwuka Eze; Julian Taugner; Alexander Nieto; Kerstin Hofstetter; Sophie Kröninger; Julian Guggenberger; Saskia Kenndoff; Benedikt Flörsch; Amanda Tufman; Niels Reinmuth; Thomas Duell; Claus Belka; Farkhad Manapov
• Keywords: Pneumonitis; Chemoradiotherapy; Durvalumab; Progression-free survival

Abstract Purpose/aim The international standard for patients with large inoperable stage III NSCLC is durvalumab consolidation after concurrent chemoradiotherapy (CRT). In this single centre observational study based on individual data, we prospectively evaluated the role of concurrent/sequential versus sequential immune checkpoint inhibition (ICI). Methods and total, 39 were enrolled, 11 (28%) treated simultaneous therapy PD-1 (nivolumab) (SIM-cohort) 28 (72%) received PD-L1 (durvalumab) as treatment up to 12 months end CRT (SEQ-cohort). Results For entire cohort, median progression-free survival (PFS) was 26.3 (OS), locoregional recurrence-free distant metastasis-free not reached. SIM-cohort, OS reached PFS 22.8 months, respectively. SEQ-cohort, neither nor After propensity score matching, at 12/24 82/44% in SIM-cohort 57/57% SEQ-cohort ( p = 0.714), 36.4/18.2% showed grade II/III pneumonitis; 18.2/13.6% PSM 0.258, 0.55). Conclusion Both ICI show a favorable side effect profile promising NSCLC. Concurrent numerical non-significant improvement regarding 6- 12-months control compared approach small study. However, associated moderate increase pneumonitis.