Planning target volume as a predictor of disease progression in inoperable stage III non-small cell lung cancer patients treated with chemoradiotherapy and concurrent and/or sequential immune checkpoint inhibition

• DOI: 10.1007/s10637-021-01143-0
• Publication Date: 2021-08-05T11:02:41Z
• Authors: Julian Taugner; Lukas Käsmann; Monika Karin; Chukwuka Eze; Benedikt Flörsch; Julian Guggenberger; Minglun Li; Amanda Tufman; Niels Reinmuth; Thomas Duell; Claus Belka; Farkhad Manapov
• Keywords: Chemoradiotherapy; Durvalumab; Progression-free survival

The present study evaluates outcome after chemoradiotherapy (CRT) with concurrent and/or sequential Programmed Cell Death 1 (PD-1) or Ligand (PD-L1) immune checkpoint inhibition (CPI) for inoperable stage III NSCLC patients depending on planning target volume (PTV).Prospective data of thirty-three consecutive treated CRT and durvalumab (67%, 22 patients) nivolumab (33%, 11 were analyzed. Different PTV cut offs as a continuous variable evaluated their association progression-free (PFS), local-regional (LRPFS), extracranial distant metastasis-free (eMFS) brain-metastasis free-survival (BMFS).All conventionally fractionated thoracic radiotherapy (TRT); 93% to total dose at least 60 Gy, 97% received two cycles platinum-based chemotherapy. Median follow-up the entire cohort was 19.9 (range: 6.0-42.4) months; median overall survival (OS), LRFS, BMFS eMFS not reached. PFS 22.8 (95% CI: 10.7-34.8) months. Patients ≥ 900ccm had significantly shorter (6.9 vs months, p = 0.020) (8.1 months vs. reached, 0.003). Furthermore, IIIC disease (UICC-TNM Classification 8th Edition) achieved very poor 3.6 (p < 0.001) reached 0.001), respectively. also significant impact 0.048). However, no different cut-offs LRPFS could be shown. multivariate analysis that performed age (≥ 65 years), gender (male), histology (non-ACC) well T- N-stage (T4, N3) covariates revealed only factor correlation (HR: 5.383 CI:1.263-22.942, 0.023)).In this prospective definitive combined CPI, observed in initial 900ccm.