Optimizing Early-Stage NSCLC Management Through Multidisciplinary Strategies: ASCO 2025 - Episode 12
PACIFIC-R 5-Year Follow-Up: Real-World Outcomes and Implications for Unresectable NSCLC Treatment
Panelists discuss how the PACIFIC-R real-world data demonstrates excellent long-term outcomes with a median survival of 60 months, validating the durvalumab consolidation approach while addressing management strategies for patients who progress on or after immunotherapy.
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Aditya Juloori, MD, discusses long-term follow-up data from the PACIFIC-R study, which reinforces the benefit of durvalumab in unresectable non–small cell lung cancer following chemoradiation. The 5-year data show durable disease control, supporting continued use of immunotherapy in this setting.
Wade Iams, MD, MSCI, and Juloori explore treatment strategies for patients with progression during durvalumab, favoring enrollment in clinical trials or use of local therapies like stereotactic radiosurgery for oligoprogressive brain disease. They caution against defaulting to chemotherapy, given its limited efficacy and high toxicity in this setting.
The panelists emphasizes that decision-making should be tailored based on progression site—brain-only progression can often be managed locally, whereas systemic progression may require a switch in systemic agents. They advocate for ongoing multidisciplinary coordination to optimize treatment sequencing and maintain disease control.
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