More PACIFIC results.

Targeted Therapy: Durvalumab, a PD-L1-targeted monoclonal antibody.
The Trial: One year ago the practice-changing initial reporting of the PACIFIC trial demonstrated that adding durvalumab 10 mg/kg q2 weeks following standard definitive chemoradiation for locally-advanced non-small cell lung cancer (NSCLC) dramatically improves median progression-free survival from 6 →17 months. As a reminder, enrollees were pretty much all-comers. Only 451 of 713 enrollees (63%) had post-hoc evaluable tumor expression of PD-L1, with one-third of those having <1% expression. What’s more, about one-third of tumors were squamous cell histologies. Median duration of durvalumab infusions was 40 weeks (of a planned 52). And now the final reporting of the co-primary endpoint of overall survival (OS): As expected, the rate of OS at 24 months was also significantly prolonged with the addition of durvalumab from 56 → 66%.
The Takeaway: The role of adjuvant durvalumab following definitive chemoradiation for all-comers with NSCLC has been cemented with the final reporting of an improvement in OS demonstrated in all pre-planned subgroups. | Antonia, N Engl J Med 2018

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