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Vienna, Austria

ESTRO 2023

Session Item

Monday
May 15
16:30 - 17:30
Business Suite 1-2
Lung 2
Cécile Le Péchoux, France
3506
Poster Discussion
Clinical
Second PFS after post-PACIFIC relapse in the Blue Sky observational study on stage 3 NSCLC.
Jessica Saddi, Italy
PD-0962

Abstract

Second PFS after post-PACIFIC relapse in the Blue Sky observational study on stage 3 NSCLC.
Authors:

Andrea Riccardo Filippi1, Jessica Saddi2, Francesco Agustoni3, Giulia Galli4, Salvatore La Mattina5, Giorgio Facheris6, Giulia Stella7, Chandra Bortolotto8, Alessandra Ferrari9, Paolo Pedrazzoli10, Lorenzo Preda11, Paolo Borghetti12

1University of Pavia, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences and Fondazione IRCCS Policlinico San Matteo, Radiation Oncology, Pavia, Italy; 2University of Milano Bicocca, Radiation Oncology, Milan, Italy; 3University of Pavia,Department of Internal Medicine and Medical Therapeutics and Fondazione IRCCS Policlinico San Matteo, Medical Oncology, Pavia, Italy; 4Fondazione IRCCS Policlinico San Matteo , Medical Oncology, Pavia, Italy; 5 Spedali Civili and University of Brescia, Brescia, Italy, Radiation Oncology, Brescia, Italy; 6Spedali Civili and University of Brescia, Brescia, Italy, Radiation Oncology, Brescia, Italy; 7University of Pavia, Department of Internal Medicine and Medical Therapeutics and Fondazione IRCCS Policlinico San Matteo , Respiratory Medicine, Pavia, Italy; 8University of Pavia, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences and Fondazione IRCCS Policlinico San Matteo , Radiology, Pavia, Italy; 9Oncology Clinical Trials Office, Fondazione IRCCS Policlinico San Matteo, Medical Oncology, Pavia, Italy; 10University of Pavia, Department of Internal Medicine and Medical Therapeutics and Fondazione IRCCS Policlinico San Matteo , Medical Oncology, Pavia, Italy; 11University of Pavia, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences and Fondazione IRCCS Policlinico San Matteo, Radiology, Pavia, Italy; 12Spedali Civili and University of Brescia, Brescia, Italy, Radiation Oncology , Brescia, Italy

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Purpose or Objective

The Blue Sky Radiomic trial is a multicenter, observational study started in 2020, enrolling a sample of 100 patients affected with unresectable stage 3A-C NSCLC treated with the PACIFIC regimen (clinicaltrial.gov identifier: NCT04364776, active, recruiting). We here report an exploratory analysis of PFS-2 after the first relapse in a cohort of 65 patients enrolled by 2 of 5 participating Centres.

Material and Methods

All patients received at least one durvalumab dose after chemoradiation (25 sequential, 38%, and 40 concurrent, 62%). Median age was 69 years old; median radiation dose was 60 Gy. All tumors were PD-L1 positive (TPS>1%). Twenty-seven had squamous (42%) and 38 (58%) non-squamous histology. The median follow-up time for the whole cohort was 18.2 months (range of 4.1-42 months).

Results

The median time of durvalumab administration for the whole cohort was 11.2 months (corresponding to an average of 22 doses). We recorded 4 deaths and 35 events of progression (local, distant, or both). Fourteen occurred <6 months from the first durvalumab administration (36%) and 25 >6 months (64%), respectively. Global PFS rate (progression at any site or death, whichever occurred first) was 59.8% at 12 months and 41% at 24 months, respectively. Median PFS was 18.3 months. Twenty-nine/35 patients (83%) received an active treatment after the first progression (20 chemotherapy, 5 radiotherapy alone, 2 chemotherapy and local treatment, one surgery, and 1 TKI, respectively), and 6 best supportive care. Among 29 patients who received an active treatment, 22 (76%) experienced a second progression at a median time of 5.3 months from the first relapse (range 1.0-25.7 months).

Conclusion

Very few reports explored PFS2 after failure of the PACIFIC regimen. In this observational study, 83% of patients did receive an active treatment at first progression, achieving a median PFS2 of 5.3 months after very heterogeneous regimens. Prospective trials are needed to improve PFS2 in this sub-group of patients, and these findings may serve as a benchmark for comparison of future experimental strategies.