Lung Cancer: Targets and Therapy (Nov 2021)
Immunotherapy for Stage III NSCLC: Durvalumab and Beyond
Abstract
Orla Fitzpatrick,1 Jarushka Naidoo1,2 1Department of Oncology, Beaumont Hospital, RCSI University of Health Sciences, Dublin, Ireland; 2Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, 21231, USACorrespondence: Jarushka NaidooBeaumont Hospital, Beaumont Road, Dublin, 9, Ireland, Tel +353 1 809-3000Email [email protected]: Immunocheckpoint inhibitors (ICIs) have altered the treatment landscape of a wide range of malignancies, including non–small cell lung cancer (NSCLC). This class of agents inhibits the interaction between PD1 and PDL1, and was shown to be efficacious in the landmark PACIFIC trial with 1 year of maintenance durvalumab (anti-PDL1 antibody). This trial demonstrated that its use as a consolidation treatment given after definitive chemoradiotherapy improved progression free survival and overall survival compared to standard-of-care treatment. In this review, we discuss both clinical trial and real-world data that have been published since PACIFIC that support the use of durvalumab for stage III unresectable NSCLC. In addition, we highlight specific populations that may require special considerations for the use of durvalumab in this setting, such as oncogene-addicted NSCLC, the toxicity of immunotherapy, and future directions in ICI research in stage III NSCLC.Keywords: lung cancer, immunotherapy, durvalumab
