Radiotherapy-free approach in inoperable locally advanced non-small-cell lung cancer: are we ready for this shift?
Mené sur 21 patients atteints d'un cancer du poumon non à petites cellules non résécable, de stade localement avancé et surexprimant PD-L1 (score de proportion tumorale : égal ou supérieur à 50% ; âge médian : 73 ans), cet essai multicentrique de phase II évalue l'efficacité, du point de vue de la survie sans progression à 2 ans, et la toxicité d'un traitement combinant pembrolizumab et chimiothérapie à base de sels de platine
Concurrent chemoradiotherapy followed by consolidation with durvalumab is the standard of care for patients with locally advanced non-small-cell lung cancer (NSCLC) who are medically or surgically inoperable, have a good performance status, and do not have actionable EGFR mutations.1 In the PACIFIC trial, consolidation treatment with durvalumab for up to 12 months after platinum-based chemoradiotherapy showed a 5-year progression-free survival rate of 33·1% (95% CI 28·0–38·2) and 5-year overall survival rate of 42·9% (38·2–47·4).2 Despite this progress, approximately half (49·0%) of patients complete a 1-year course of durvalumab, mainly due to disease progression or adverse events. The most frequent adverse events causing treatment discontinuation were pneumonitis or radiation pneumonitis (6·3%) and pneumonia (1·1%).3 Consolidation with durvalumab or sugemalimab for 2 years has also shown progression-free survival benefits in patients who received sequential chemoradiotherapy, including those unsuitable for concurrent treatment.
The Lancet Oncology , commentaire, 2025