TOPLINE:

Durvalumab administered after chemoradiotherapy was effective and was associated with prolonged overall survival and progression‑free survival in patients with unresectable, stage III non-small cell lung cancer (NSCLC), a real-world multicentre study found.

METHODOLOGY:

• Researchers conducted a multicentre, non-interventional cohort study involving 114 adult patients (58.7% men) with locally advanced, unresectable, stage III NSCLC initiated on durvalumab following concurrent or sequential chemoradiotherapy from 10 centres across the UK between September 2017 and December 2019.
• Patients received durvalumab at a starting dose of 10 mg/kg following platinum-based chemoradiotherapy, with 85% receiving concurrent chemoradiotherapy (mean radiation dose, 61.2 Gy; mean number of fractions per patient, 28.9). They were followed up for at least 24 months from durvalumab initiation unless they died or were lost to follow-up.
• The primary outcome was the real-world overall survival rate at 12 and 24 months following the initiation of durvalumab.
• Secondary outcomes included real-world progression-free survival and second progression-free survival rates, best overall response, time to treatment discontinuation, and time to the first subsequent therapy.

TAKEAWAY:

• The median real-world overall survival was 35.9 months (95% CI, 35.9 to not reached [NR]), with 12- and 24-month survival rates of 80.2% (95% CI, 73.1%-88.0%) and 63.0% (95% CI, 54.1%-73.4%), respectively.
• The median real-world progression-free survival was 28.5 months (95% CI, 16.4 to NR), with survival rates of 61.1% (95% CI, 52.6%-70.9%) at 12 months and 54.2% (95% CI, 45.3%-64.7%) at 24 months.
• The median real-world second progression-free survival was 35.9 months (95% CI, 35.9 to NR); the survival rate was 76.2% (95% CI, 68.6%-84.6%) at 12 months and 62.6% (95% CI, 53.7%-73.1%) at 24 months. The median time to the first subsequent therapy was 34.9 months (95% CI, 21.0 to NR); a total of 69.4% and 55.8% of patients had not started any subsequent therapy at 12 and 24 months, respectively.
• Overall, 28.9% of patients discontinued durvalumab due to adverse events; pneumonitis or interstitial lung disease was the most common cause, affecting 16.7% of patients.

IN PRACTICE:

"CODAK demonstrates the effectiveness of durvalumab following CRT [chemoradiotherapy] in a real-world UK cohort of patients with unresectable, stage III NSCLC," the authors wrote, adding that "rwOS [real-world overall survival] at 12 and 24 months was consistent with the PACIFIC trial, and rwPFS [real world progression-free survival] at 12 months was comparable." "Overall, the results of CODAK support evidence from other observational studies indicating that, in real-world clinical practice, the PACIFIC regimen is an effective SOC [standard of care] for patients with unresectable, stage III NSCLC," they concluded.

SOURCE:

This study was led by Kevin Franks, Leeds Cancer Centre, St James's University Hospital, Leeds, England. It was published online on October 09, 2025, in Clinical Oncology.

LIMITATIONS:

Retrospective data collection might have missed information. Tumour responses were not evaluated according to a standard protocol. This study documented adverse events only if they resulted in treatment interruption or discontinuation. The timing of adverse events was not analysed, making it unclear whether adverse event-related interruptions correlated with treatment duration.

DISCLOSURES:

This work was funded by AstraZeneca UK. Several authors reported receiving grants and consulting fees and having other ties with various sources. Two authors reported being employees of AstraZeneca and holding stock in the company. Full disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.