Surgical Outcomes With Neoadjuvant Durvalumab Plus Chemotherapy Followed by Adjuvant Durvalumab in Resectable NSCLC

Area of Science:

• Oncology
• Thoracic Surgery
• Immunotherapy

Background:

• The AEGEAN trial evaluated perioperative durvalumab plus neoadjuvant chemotherapy for resectable non-small cell lung cancer (NSCLC).
• Previous results demonstrated significant improvements in event-free survival and pathologic complete response with durvalumab.
• This analysis focuses on the surgical outcomes and safety profile of this perioperative treatment strategy.

Purpose of the Study:

• To report the surgical outcomes from the AEGEAN trial.
• To assess the impact of perioperative durvalumab on surgical feasibility, approach, type, timing, and safety.
• To compare surgical results between patients receiving durvalumab plus chemotherapy and those receiving chemotherapy alone.

Main Methods:

• Patients with resectable NSCLC (stage II-IIIB) were randomized to receive neoadjuvant chemotherapy with either durvalumab or placebo.
• Surgical outcomes were summarized using descriptive statistics for the modified intention-to-treat (mITT) population.
• Key metrics included surgery rates, completion rates, timing, procedure types, resection margins, and complications.

Main Results:

• 80.6% and 80.7% of patients in the durvalumab and placebo arms, respectively, underwent surgery.
• R0 resection rates were numerically higher with durvalumab (94.7%) versus placebo (91.3%).
• Surgical complications were similar between arms (59.1% vs. 60.1%), primarily low-grade.

Conclusions:

• Perioperative durvalumab addition to neoadjuvant chemotherapy did not negatively impact surgical outcomes in resectable NSCLC.
• The surgical safety profile was tolerable and comparable to neoadjuvant chemotherapy alone.
• These findings support the use of perioperative durvalumab in this patient population.