1069 Real-world experience with durvalumab amongst older patients
Bibliographic record
Abstract
Background One-third of patients with non-small cell lung cancer (NSCLC) are diagnosed with stage III, locally advanced disease. Older adults with cancer often have more complex health and supportive care needs compared to their younger patients. The aim of this study was to assess outcomes and healthcare utilization among older patients with stage III NSCLC who were treated with concurrent chemoradiation followed by durvalumab at our hospitalMethods We conducted a retrospective cohort study at a single institution involving patients over 65 years old with stage III NSCLC who were treated with chemoradiation followed by durvalumab. Data collection included baseline characteristics, treatment protocols, emergency room (ER) visits, hospitalizations, treatment-related toxicity, and utilization of home health care servicesResults A total of 60 patients were included in the study, with a median age of 72 years; 50% (30) were female. Among the patients, 38% (23) were current smokers and 48% (29) were former smokers. EGFR mutations were present in 13% (8) of patients. PD-L1 expression was <1% in 81% (49) of patients, 1–49% in 6% (4), and ≥50% in 10% (6).The most common chemotherapy was a carboplatin histology-based doublet in 33 (55%) of patients, most commonly using a 3-week regimen. Only 50% (30) of patients completed all durvalumab treatment cycles. The primary reasons for durvalumab discontinuation were disease progression (58% - 17 patients) and pneumonitis (40% - 12 patients).The most common durvalumab-related toxicities were pneumonitis (43% - 13 patients) and hypothyroidism (40% - 12 patients). There were 26 (43%) patients with emergency room visits and 35% (21 patients) hospitalizations during treatment. There were 5 patients that used the home care service use. Median progression-free survival (PFS) was 26.2 (CI 8.7 -43.7) months. Intrathoracic recurrence occurred in 47% of patients and extrathoracic in 29%, including 22% with brain metastases. Recurrence during durvalumab treatment was observed in 21% of patients, with the most common site of progression being intrathoracic (76%). OS was 51 months (CI 40-61)Conclusions In this real-world cohort of older adults with stage III NSCLC treated with chemoradiation followed by durvalumab, treatment completion rates were low, and toxicity—particularly pneumonitis—was a frequent cause of discontinuation. There were high rates of ER visits and hospitalizations, while home care service use was low. These findings underscore the need for personalized treatment strategies and enhanced supportive care in this vulnerable population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".