ArticleTherapeutic advances in medical oncology2026
Clinical management and outcomes of relapsed NSCLC after chemoradiotherapy and durvalumab consolidation: real-world evidence from Germany.
Article in Therapeutic advances in medical oncology, 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: Despite recent advances in the treatment of locally advanced non-small cell lung cancer (NSCLC), most patients relapse after definitive chemoradiotherapy followed by durvalumab consolidation. Due to limited evidence on post-relapse management, no standard treatment approach has been established for this patient population. Objectives: The objective of this study was to evaluate real-world treatment strategies and clinical outcomes in patients with NSCLC who experienced disease recurrence after durvalumab consolidation. Design: This was a multicenter, retrospective cohort study conducted across 12 German lung cancer centers. Methods: A total of 145 patients with recurrent NSCLC following chemoradiotherapy and durvalumab consolidation were analyzed. Clinical, pathological, and treatment-related data were collected, including smoking status, histology, molecular testing, therapeutic sequences, and survival outcomes. Overall survival (OS) and progression-free survival (PFS) were estimated and compared across subgroups according to relapse characteristics and post-relapse treatment strategies. Multivariate analyses were performed to identify independent prognostic factors. Results: The median OS from initial diagnosis was 27.1 months (95% confidence interval (CI): 22.5-31.8). After relapse, median OS was 12.2 months (95% CI: 9.9-14.4), and median PFS was 7.1 months (95% CI: 5.7-8.4). Approximately 70% of patients received systemic therapy after relapse, including platinum-based chemotherapy (18.6%), single-agent chemotherapy (18.6%), immune checkpoint inhibitors with or without chemotherapy (28.3%), and targeted therapy (4.8%). Patients treated with immune checkpoint inhibitors or targeted therapies showed a numerical improvement in OS compared with chemotherapy alone, although this difference did not reach statistical significance. Multivariate analysis identified first-line post-relapse treatment, Eastern Cooperative Oncology Group performance status, and histologic subtype as independent prognostic factors for OS. Conclusion: Patients with relapsed NSCLC after durvalumab consolidation have a poor prognosis and remain a therapeutically underserved population. Clinical outcomes appear to be influenced by performance status, histology, and the choice of post-relapse therapy. Prospective clinical trials are urgently needed to define optimal treatment strategies for these patients.
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