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WCLC 2025 | EA5181: timing of durvalumab with CRT in unresectable stage III NSCLC
John Varlotto, MD, Marshall University, Huntington, WV, discusses results from the Phase III EA5181 trial (NCT04092283) of concurrent plus consolidative durvalumab with chemoradiotherapy (CRT) versus consolidative durvalumab alone in unresectable stage III non-small cell lung cancer (NSCLC). Overall survival and progression-free survival were similar between arms, with no significant differences in response rates, recurrence patterns, or toxicity. These findings suggest that initiating durvalumab concurrently with CRT does not improve outcomes compared to consolidation alone. This interview took place at 2025 World Conference on Lung Cancer (WCLC) in Barcelona, Spain.
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Transcript
It’s a great honor to present at our presidential symposium here at the IASLC meeting. I presented ECOG-ACRIN EA5181, which really was looking at trying to improve outcomes with locally advanced unresectable stage 3 non-small cell lung cancer. This trial basically looked at randomizing patients to chemoradiation therapy or chemoradiation with concomitant durvalumab...
It’s a great honor to present at our presidential symposium here at the IASLC meeting. I presented ECOG-ACRIN EA5181, which really was looking at trying to improve outcomes with locally advanced unresectable stage 3 non-small cell lung cancer. This trial basically looked at randomizing patients to chemoradiation therapy or chemoradiation with concomitant durvalumab. And both arms were followed by consolidative durvalumab, which was proven by the PACIFIC trial. So both arms, if you did not progress, did not experience pneumonitis and had toxicities of grade 2 or less within 45 days, you could proceed to consolidate durvalumab. It should be noted that during the concurrent phase, we gave 750 milligrams every two weeks. Consolidation was 1,500 milligrams every month for up to 12 months. Yes, the primary endpoint with EA5181 was looking at improving overall survival compared to the Pacific regimen versus chemoradiation therapy followed by consolidated durvalumab. We were looking at improving survival by also giving the addition of concomitant durvalumab during the course of chemoradiation therapy. Our secondary endpoints included progression-free survival, recurrence rates, overall response rates, and also toxicity. And those are the secondary endpoints that we looked at.
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