The PACIFIC-06 Study

At ESMO 2023, exciting data on lung cancer were presented, including insights from the PACIFIC-06 study. The study was presented by Prof Marina Garassino, from the University of Chicago.

In a distinct context within the domain of Small Cell Lung Cancer (SCLC), the spotlight falls on patients for whom surgical intervention is deemed unfeasible. For these individuals, the conventional course of action often involves a combination of chemotherapy and radiotherapy. Approximately half of SCLC patients in Belgium, as well as those in France and throughout Europe, do not receive concurrent treatment. The primary reason behind this variation in treatment approach lies in the presence of comorbidities and the frailty of these patients.

The PACIFIC-6 trial, designed to address this specific clinical scenario, explores an alternative treatment strategy, which entails sequential chemoradiotherapy followed by consolidation therapy. The central objective of this trial is to ascertain whether patients following this sequential regimen can achieve outcomes on par with their counterparts in the original Pacific trial, where concurrent chemoradiotherapy was employed. Although patients in the Pacific 6 trial might exhibit less robust health, preliminary findings hint at promising efficacy.

At the one-year mark, the overall survival rate hovers around an impressive 60% to 65%, particularly noteworthy given the patient population’s challenges. Additionally, the incidence of treatment-related adverse events remains relatively low. Notably, pneumonitis occurs in only about 10% to 11% of patients. Furthermore, adverse events associated with durvalumab, a checkpoint inhibitor utilised in this study, are recorded at approximately 4% at six months and 6% overall. However, it’s important to acknowledge that pinpointing the exact cause of these side effects, whether radiation, medication or a combination of factors, can be a complex endeavour.

These findings demonstrate that durvalumab after sequential chemoradiotherapy is well tolerated and could be a reasonable strategy when concurrent chemoradiotherapy is not possible.

Reference:

Marina Garassino – Durvalumab after sequential chemoradiotherapy in patients with unresectable Stage III NSCLC: Final analysis from PACIFIC-6 – ESMO 2023 – # LBA61