Portal de investigación
Durvalumab After Chemoradiation for Unresectable Stage III Non-Small Cell Lung Cancer: Inferior Outcomes and Lack of Health Equity in Hispanic Patients Treated With PACIFIC Protocol (LA1-CLICaP)
Fecha de publicación:
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Autores organización
Autores
- Raez LE
- Arrieta O
- Chamorro DF
- Soberanis-Piña PD
- Corrales L
- Martín C
- Cuello M
- Samtani S
- Recondo G
- Mas L
- Zatarain-Barrón ZL
- Ruíz-Patiño A
- García-Robledo JE
- Ordoñez-Reyes C
- Jaller E
- Dickson F
- Rolfo C
- Rosell R
Grupos de investigación
Resumen
Objectives: To compare the rate disparity between outcomes (overall survival (OS), progression-free survival (PFS), and safety) of concurrent chemoradiation (cCRT) followed by durvalumab in two patient cohorts with locally advanced (LA) stage III non-small cell lung cancer (NSCLC), one non-Hispanic White (NHW), and the other Latin-American. Methods: A multicenter retrospective study was performed, including 80 Hispanic and 45 NHW LA stage III NSCLC patients treated with cCRT followed by durvalumab. Both cohorts were analyzed in terms of main outcomes (OS, PFS, and safety) and compared between them and with the PACIFIC trial population outcomes. The efficacy-effectiveness gap was assessed using an efficacy-effectiveness (EE) factor that was calculated by dividing each cohort median overall survival by the corresponding reference OS from the PACIFIC trial. In both cohorts, results of PD-L1 testing were recorded, and the main outcomes were compared according to PD-1 expression levels (=50%, 1–49%, and <1%). Results: For the entire population (N=125), the overall response rate (ORR) was 57.6% (N=72), and 18.4% (N=25) achieved stable disease. OS was 26.3 months (95%CI 23.9-28.6), and PFS was 20.5 months (95%CI 18.0-23.0). PFS assessed by ethnicity showed a median for the Hispanic population of 19.4 months (95%CI 16.4-22.5) and 21.2 months (95%CI 17.2-23.3; p=0.76) for the NHW group. OS by race showed a significant difference in favor of the NHW group, with a median OS of 27.7 months (95%CI 24.6-30.9) vs. 20.0 months (95%CI 16.4-23.5) for Hispanics. (P=0.032). Unadjusted 12-month and 24-month OS was 86.6% (95%CI 79.9–88.0) and 46.6% (95%CI 40.2–48.3) for NHW compared to 82.5% (95%CI 77.1–84.2) and 17.5% (95%CI 15.6-24.5) in Hispanics. NHW had an EE factor of 0.78 and Hispanics had 0.58, showing a reduction in survival versus NHW and PACIFIC of 20% and 42%, respectively. HR for the OS among NHWs and Hispanics was 1.53 (95%CI 1.12-1.71; P=0.052) and 2.31 (95%CI 1.76-2.49; P=0.004). Fifty-six patients (44.8%) had some degree of pneumonitis due to cCRT plus durvalumab. There was no difference in the proportion of pneumonitis according to race (P=0.95), and the severity of pneumonitis was not significantly different between Hispanics and NHWs (P=0.41). Conclusions: Among patients with LA stage III NSCLC, NHW had better survival outcomes when compared to Hispanics, with an OS that seems to favor the NHW population and with an EE factor that shows a shorter survival in Hispanics compared with NHW and with the PACIFIC trial group. Copyright © 2022 Raez, Arrieta, Chamorro, Soberanis-Piña, Corrales, Martín, Cuello, Samtani, Recondo, Mas, Zatarain-Barrón, Ruíz-Patiño, García-Robledo, Ordoñez-Reyes, Jaller, Dickson, Rojas, Rolfo, Rosell and Cardona.
Copyright © 2022 Raez, Arrieta, Chamorro, Soberanis-Piña, Corrales, Martín, Cuello, Samtani, Recondo, Mas, Zatarain-Barrón, Ruíz-Patiño, García-Robledo, Ordoñez-Reyes, Jaller, Dickson, Rojas, Rolfo, Rosell and Cardona.
Datos de la publicación
- ISSN/ISSNe:
- 2234-943X, 2234-943X
- Tipo:
- Article
- Páginas:
- 904800-904800
- Enlace a otro recurso:
- www.scopus.com
Frontiers In Oncology Frontiers Media S.A.
Citas Recibidas en Web of Science: 3
Citas Recibidas en Scopus: 7
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Filiaciones
Keywords
- durvalumab; programmed death 1 ligand 1; programmed death 1 receptor; aged; Article; cancer staging; cancer survival; chemoradiotherapy; cohort analysis; drug efficacy; drug safety; female; gene expression; health equity; Hispanic; human; immunotherapy; major clinical study; male; multicenter study; non small cell lung cancer; outcome assessment; overall response rate; overall survival; pneumonia; positron emission tomography-computed tomography; progression free survival; retrospective study
Proyectos asociados
EFECTO DEL EXTRACTO DE Trametes versicolor SOBRE EL FENOTIPO Y LA FUNCIÓN DE CÉLULAS DENDRÍTICAS HUMANAS CONDICIONADAS CON MEDIOS DE CÉLULAS DE CARCINOMA ORAL
Investigador Principal: ANDRES FELIPE CARDONA MENDOZA
PCI-2019-10805 . 2020
Citar la publicación
Raez LE,Arrieta O,Chamorro DF,Soberanis PD,Corrales L,Martín C,Cuello M,Samtani S,Recondo G,Mas L,Zatarain ZL,Ruíz A,García JE,Ordoñez C,Jaller E,Dickson F,Rojas L,Rolfo C,Rosell R,Cardona AF. Durvalumab After Chemoradiation for Unresectable Stage III Non-Small Cell Lung Cancer: Inferior Outcomes and Lack of Health Equity in Hispanic Patients Treated With PACIFIC Protocol (LA1-CLICaP). Front Oncol. 2022. 12. p. 904800-904800. IF:4,700. (2).