ArticleTranslational lung cancer research2026
Real-world outcomes of consolidative durvalumab after concurrent chemoradiotherapy in stage III non-small cell lung cancer: the prognostic role of clinical frailty in the post-PACIFIC era.
Article in Translational lung cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Consolidative durvalumab following concurrent chemoradiotherapy (CCRT) is the current standard of care for unresectable stage III non-small cell lung cancer (NSCLC). However, survival outcomes in real-world populations remain variable. We evaluated the independent association between consolidative durvalumab and survival outcomes in a real-world cohort. Methods: This retrospective single-center study included 108 patients with unresectable stage III NSCLC treated with definitive CCRT between 2017 and 2022. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan-Meier estimates and multivariable Cox regression models. Baseline Clinical Frailty Scale (CFS) scores were assigned retrospectively. Multivariable logistic regression was performed to assess factors associated with durvalumab initiation. Results: Among 108 patients, 50 received consolidative durvalumab and 58 did not. Median follow-up was 16.5 months. In multivariable analysis, durvalumab was independently associated with improved OS [hazard ratio (HR) 0.16, 95% confidence interval (CI): 0.06-0.39; P<0.001]. No independent association was observed between durvalumab and PFS (HR 0.84, 95% CI: 0.44-1.58; P=0.59). In patients with programmed death-ligand 1 (PD-L1) expression ≥1%, durvalumab remained independently associated with improved OS (HR 0.43, 95% CI: 0.21-0.87; P=0.02), but not PFS. Baseline frailty was not independently associated with durvalumab initiation. Grade ≥3 adverse events occurred in 8.3% of patients, with no grade 4-5 toxicities observed. Conclusions: In this real-world cohort, consolidative durvalumab was independently associated with improved OS, including in patients with PD-L1 expression ≥1%. The absence of an independent PFS association underscores the complexity of survival interpretation in heterogeneous clinical populations.
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