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Efficacy and safety of consolidation durvalumab after chemoradiation therapy for stage III non-small-cell lung cancer: a systematic review, meta-analysis, and meta-regression of real-world studies

Affiliation
Evidence-Based Medicine Center ,School of Basic Medical Sciences ,Lanzhou University ,Lanzhou ,China
Zhang, Yatong;
Affiliation
School of Nursing ,Hunan University of Medicine ,Huaihua ,Hunan ,China
Tian, Yumei;
Affiliation
Evidence-Based Medicine Center ,School of Basic Medical Sciences ,Lanzhou University ,Lanzhou ,China
Zheng, Li;
Affiliation
Department of Pharmacy ,Beijing Hospital ,Beijing ,China
Sun, Xuelin;
Affiliation
Department of Pharmacy ,Beijing Hospital ,Beijing ,China
Zhao, Zinan;
Affiliation
Department of Pharmacy ,Beijing Hospital ,Beijing ,China
Zheng, Yujing;
Affiliation
Evidence-Based Medicine Center ,School of Basic Medical Sciences ,Lanzhou University ,Lanzhou ,China
Tian, Jinhui

Background: The current review aimed to pool real-world evidence on the efficacy and toxicity of consolidation durvalumab for stage III unresectable non-small cell lung cancer (NSCLC) after curative chemoradiotherapy. Methods: PubMed, CENTRAL, ScienceDirect, Embase, and Google Scholar were searched for observational studies reporting the use of durvalumab for NSCLC till 12th April 2022. Twenty-three studies with 4,400 patients were included. Results: The pooled 1-year overall survival (OS) and progression-free survival rates (PFS) were 85% (95% CI: 81%–89%) and 60% (95% CI: 56%–64%) respectively. Pooled incidence of all-grade pneumonitis, grade ≥3 pneumonitis and discontinuation of durvalumab due to pneumonitis were 27% (95% CI: 19%–36%), 8% (95% CI: 6%–10%) and 17% (95% CI: 12%–23%) respectively. The pooled proportion of patients experiencing endocrine, cutaneous, musculoskeletal, and gastrointestinal adverse events was 11% (95% CI: 7%–18%), 8% (95% CI: 3%–17%), 5% (95% CI: 3%–6%), and 6% (95% CI: 3%–12%), respectively. Conclusion: Meta-regression indicated that performance status significantly influenced PFS, while age, time to durvalumab, and programmed death-ligand 1 status significantly affected pneumonitis rates. Real-world evidence suggests that the short-term efficacy and safety of durvalumab are consistent with that of the PACIFIC trial. The congruence of results lends support to durvalumab use in improving outcomes of unresectable stage III NSCLC. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324663 , identifier CRD42022324663.

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License Holder: Copyright © 2023 Zhang, Tian, Zheng, Sun, Zhao, Zheng and Tian.

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