Identification of predictive factors for early relapse in patients with unresectable stage Ⅲ NSCLC receiving consolidation durvalumab after concurrent chemoradiation therapy

Background: Patients with locally advanced, unresectable, non-small cell lung cancer (NSCLC) receiving definitive concurrent chemoradiation therapy (CCRT) benefit from durvalumab consolidation therapy. However, predictive factors for early relapse during durvalumab maintenance have not yet been identified. Methods: The present study included the lung cancer cohort of the Catholic Medical Centers of Korea from January 2018 to December 2021. A total of 51 NSCLC patients treated with durvalumab consolidation therapy after definitive CCRT were included in the analysis. Early relapse was defined as patients experiencing relapse within 6 months of starting initial durvalumab therapy. Results: Among the 51 patients, 15 (29.4%) relapsed during the study period. Median time from initial therapy with durvalumab to progression was 107.73 ± 47.69 days in the early relapse patients. In multivariate analysis, younger age (adjusted hazard ratio [aHR], 0.713; 95% confidence interval [CI] 0.572–0.888; P = 0.003), higher pack-years (aHR, 1.311; 95% CI, 1.109–1.549; P = 0.001), non-COPD (aHR, 0.030; 95% CI, 0.001–0.677; P = 0.027), anemia (aHR, 23.30; 95% CI, 2.030–267.48; P = 0.011), and stage ⅢC (vs. stage ⅢA; aHR, 17.890; 95% CI, 1.997–160.243; P = 0.010) were independent predictive factors for early relapse during durvalumab consolidation therapy. Conclusion: Younger age, higher number of pack-years, non-COPD, anemia, and stage ⅢC were independent predictive factors for early relapse during durvalumab consolidation. Careful patient selection and clinical attention are needed for high-risk individuals.