Consolidative durvalumab outcomes in stage III non-small cell lung cancer in a multi-centre study
Bibliographic record
Abstract
AIM: To investigate the impact of PD-L1 expression status on consolidative durvalumab efficacy and safety in stage III NSCLC patients. METHODS: This retrospective, ethics board approved, multi-centre study included all patients with histologically and/or cytologically confirmed unresectable stage III NSCLC, EGFR/ALK wild-type patients who completed concurrent chemoradiation therapy (cCRT) from January 2018 to August 2020 at the Cancer Centre of Southeastern Ontario and The Ottawa Hospital Cancer Centre. PD-L1 status was grouped as ≥50% vs. 1-49% vs. <1%. Primary study endpoint was overall survival (OS). RESULTS: Of the total 63 patients, 27 (43%), 16 (25%), 8 (13%), and 12 (19%) patients in the PD-L1 ≥50%, PD-L1 1-49%, PD-L1 <1%, and PD-L1 unknown groups (reported separately), respectively. With the median follow-up of 17.0 months, our multivariable Cox analysis suggested PD-L1≥50% was independently associated with improved OS compared to PD-L1<1% group (HR 0.18, 95%CI 0.04-0.86, P = 0.03). There were no significant differences in OS outcomes between PD-L1 1-49% and PD-L1 <1% group (HR 0.36, 95%CI 0.08-1.63, P = 0.18). Any grade treatment-related pneumonitis was observed in 46% of patients. Sixty-two percent, 38%, and 18% of patients required systemic corticosteroid use, hospitalization, and permanent treatment discontinuation due to pneumonitis, respectively. CONCLUSIONS: Our multi-centre, real-world study supported the use of consolidative durvalumab in inoperable stage III PD-L1 expressing NSCLC. Pneumonitis was significant, and higher than expected. Benefit appeared greater in high PD-L1 expressing patients, consistent with the subgroup analysis from the landmark PACIFIC trial. Our results need to be interpreted with cautions due to small sample size and a relatively short follow-up duration.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".