Final efficacy outcomes of atezolizumab with chemoradiation for unresectable NSCLC: The phase II DETERRED trial Journal Article


Authors: Liu, Y.; Yao, L.; Kalhor, N.; Carter, B. W.; Altan, M.; Blumenschein, G.; Byers, L. A.; Fossella, F.; Gibbons, D. L.; Kurie, J. M.; Lu, C.; Skoulidis, F.; Chang, J. Y.; Liao, Z.; Gomez, D. R.; O'Reilly, M.; Heymach, J. V.; Tsao, A. S.; Lin, S. H.
Article Title: Final efficacy outcomes of atezolizumab with chemoradiation for unresectable NSCLC: The phase II DETERRED trial
Abstract: Introduction: The phase II DETERRED trial assessed the safety and efficacy of consolidation and concurrent immunotherapy with chemoradiation in unresectable locally advanced non-small cell lung cancer. We present updated efficacy analysis of this trial. Methods: The trial was conducted in 2 parts with patients in part 1 (n = 10) receiving chemoradiation with consolidation atezolizumab, while patients in part 2 (n = 30) received concurrent and consolidation atezolizumab. Progression-free survival (PFS), time to second progression (PFS2), and overall survival (OS) were assessed using Kaplan-Meier analysis. Subset analyses were performed by programmed cell death ligand-1 (PD-L1) status and targetable driver oncogene mutation status. Results: At a median follow-up of 39.2 months, the median PFS for part 1 was 18.9 months and 15.1 months for part 2. Median OS for part 1 was 26.5 months and was not reached for part 2. For the cohort, 3-year OS was 53.8%, while 4-year OS was 47.4%. Patients with targetable driver oncogene mutations had a median PFS of 9.4 months and OS of not reached compared to 16.6 months (HR: 3.49, p = 0.02) and 26.9 months (HR: 0.40, p = 0.12) respectively compared to those without targetable driver oncogene mutations. Patients with PD-L1 < 1% had median PFS of 11.0 months and OS of 26.5 months compared to 27.4 months (HR: 2.01, p = 0.10) and not reached (HR: 1.49, p = 0.41) respectively for those with PD-L1 ≥ 1%. Conclusions: In the DETERRED trial, chemoradiation with concurrent and/or consolidative atezolizumab led to comparable efficacy as consolidative durvalumab in the PACIFIC trial. The presence of targetable driver oncogene mutations led to worse PFS, while PD-L1 < 1% trended to worse PFS. © 2022 Elsevier B.V.
Keywords: adult; cancer survival; controlled study; treatment response; gene mutation; major clinical study; overall survival; advanced cancer; drug efficacy; drug safety; paclitaxel; comparative study; outcome assessment; follow up; carboplatin; cancer immunotherapy; progression free survival; controlled clinical trial; multiple cycle treatment; phase 2 clinical trial; radiation; oncogene; immunotherapy; add on therapy; targeted therapy; kaplan meier method; drug dose increase; non-small cell lung cancer; chemoradiotherapy; programmed death 1 ligand 1; non small cell lung cancer; molecularly targeted therapy; comparative effectiveness; driver mutations; human; article; durvalumab; atezolizumab; regulated cell death
Journal Title: Lung Cancer
Volume: 174
ISSN: 0169-5002
Publisher: Elsevier Ireland Ltd.  
Date Published: 2022-12-01
Start Page: 112
End Page: 117
Language: English
DOI: 10.1016/j.lungcan.2022.10.006
PUBMED: 36371941
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 December 2022 -- Source: Scopus
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  1. Daniel R Gomez
    237 Gomez