Durvalumab consolidation after chemoradiotherapy for locoregional recurrent non-small cell lung cancer

Locoregional recurrence is one of the main failure patterns following curative treatment for non-small cell lung cancer (NSCLC). Although an optimal treatment strategy for patients with locoregional recurrence has not yet been established, chemoradiotherapy (CRT) is widely used in clinical practice. Treatment with CRT followed by durvalumab, a programmed death ligand 1 inhibitor, has become the standard treatment for unresectable locally advanced NSCLC. However, the efficacy of durvalumab consolidation therapy for locoregional recurrent NSCLC remains unclear. Therefore, patients with NSCLC treated with CRT at the Kyoto University Hospital (Kyoto, Japan) between January 2010 and December 2022, were retrospectively analyzed. The efficacy and safety of durvalumab consolidation between patients with locoregionally recurrent and locally advanced NSCLC who received treatment and those who did not were compared. Among 198 patients with NSCLC treated with CRT, 43 had a locoregional recurrence and 12 received durvalumab consolidation. The median progression-free survival (PFS) was not reached in the durvalumab group and was 13.6 months in the non-durvalumab group [hazard ratio (HR), 0.69; 95% confidence interval, 0.28-1.71; P=0.42). The 12-, 18-, and 24-month PFS rates in the durvalumab group were 58.3, 58.3, and 50.0%, respectively. Pneumonitis was more frequent in the durvalumab group; however, no grade 3 or higher cases were observed. In conclusion, durvalumab consolidation after CRT for locoregional recurrent NSCLC demonstrated favorable efficacy and acceptable toxicity compared with treatment without durvalumab. Similar to patients with locally advanced NSCLC, those with locoregionally recurrent NSCLC may benefit from durvalumab consolidation therapy after CRT.