Post-progression treatment strategies and immunotherapy rechallenge sensitivity following chemoradiation and consolidation durvalumab in unresectable stage III NSCLC: The POST-PACIFIC study.

作者：Valentina Santo, Nikhil Mankuzhy, Kristi Beshiri, Alix Celarier, Lingzhi Hong, Emanuele C. Mingo, Sagal Pannu, Federica Pecci, Edoardo Garbo, Eleonora Gariazzo, Leonardo Brunetti, Ayesha Aijaz, Federico Monaca, Jamie E. Chaft, Marcelo Corassa, Alessio Cortellini, Natalie I. Vokes, M Aldea, Narek Shaverdian, Biagio Ricciuti · 发表于：Journal of Clinical Oncology · 年份：2026 · DOI：10.1200/jco.2026.44.16_suppl.8048 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Diagnosis and Treatment、Radiomics and Machine Learning in Medical Imaging

8048 Background: Durvalumab consolidation after platinum-based chemoradiotherapy (CRT) is the standard of care for unresectable stage III non-small cell lung cancer (NSCLC). However, optimal treatment strategies after progression remain undefined, and data guiding post-durvalumab strategies, including immunotherapy rechallenge, are limited. Methods: This global retrospective multicenter study included patients with unresectable stage III NSCLC treated with concurrent or sequential CRT who progressed after ≥1 dose of durvalumab consolidation. Survival outcomes were assessed using Kaplan-Meier and Cox methods. Immunotherapy sensitivity was defined by time from durvalumab initiation to progression: refractory (< 12 months) or sensitive (≥12 months) and correlated with outcomes after immunotherapy rechallenge. Results: Among 319 patients, median age was 66.5 years; 54.2% were male, and 96.7% had ECOG PS 0-1. Concurrent CRT was delivered in 96.5% (median RT dose 60 Gy). Median follow-up was 62.2 months. Progression pattern included locoregional recurrence in 34.8% and distant relapse in 65.2%. Of 293 patients receiving a first subsequent therapy (FST), chemotherapy (CT) ± VEGF inhibition was most common (31.7%), followed by local ablative therapy (LAT, 30.7%), immunotherapy ± CT (18.4%), targeted therapy (TT, 10.9%), and durvalumab beyond progression (BP) ± LAT (6.5%). When comparing FST, immunotherapy rechallenge demonstrated superiority over CT. Compared with CT ± VEGF inhibi...