N Engl J Med 2017 Nov 16
Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer.
Related Questions
If given options of liver, lung, spine, brain, axilla, or other lymph nodes which sites do you pick?
New answer by Radiation Oncologist at University of Colorado School of Medicine (December 19, 2017)
I am aware of only one prospective trial structured to approach this question to some extent. It was from Jim Welsh's team at MDAH and was presented at ASTRO this year.http://...
If you treat pre-chemotherapy volumes, is there a benefit to induction chemotherapy even in bulky disease. If so, how do you define disease that ...
New answer by Radiation Oncologist at Yale School of Medicine (February 6, 2018)
Agree. My first response was to say "never" but I would revise to "almost never". If you have a patient with a large tumor volume where your normal tissue dose is high and y...
Would starting with chemotherapy be preferred in this situation and consider concurrent radiation, then switch over to Pembrolizumab once some control...
New comment by Medical Oncologist at Dayton Physicians Network Hematology ( September 29, 2018)
Thank you Dr Halmos and Dr Ohri for such an excellent breakdown of the index question and the follow up answers, made for an excellent read!
What factors do you use to decide between weekly low-dose carboplatin and paclitaxel combination vs cisplatin based doublet, and do you routinelt...
New answer by Medical Oncologist at The Ohio State University School of Medicine (August 12, 2022)
There is a discussion about this topic in the era of PACIFIC which can be found here.
There is no primary and no distant disease seen on restaging PET. RTOG 0236 shows significant regional failure rate. Some have reported salv...
New comment by Radiation Oncologist at Wellspring Oncology ( January 5, 2019)
It will be interesting to see the initial staging of the patients before SBRT; surgically vs radiologically
Do you offer consolidation chemotherapy prior to durvalumab in locally advanced, unresectable NSCLC?
In clinical practice, consolidation chemotherapy is sometimes used, though this was not implemented in the PACIFIC trial.Antonia et al., PMID 28885881...
New comment by Medical Oncologist at NYU Winthrop Hospital ( July 13, 2019)
I start Durvalumab after completion of
Chemotherapy and Radiation as per Pacific trial.
It increases PFS and OS.
In patients who have a mixed response or progression and are poor candidates for other systemic agents, would you consider consolidating the chest? Wo...
New comment by Radiation Oncologist at Wake Forest School of Medicine ( December 17, 2019)
What do you include in your treatment volumes after excellent response to chemo immuno with loss of avidity in several previously involved areas? Do you treat the pre-chemo/im...
Prior to the PACIFIC trial, patients were treated with definitive chemo/rads. With local recurrence <1yr after chemorads and definitive treatment f...
New answer by Medical Oncologist at Albert Einstein College of Medicine at Montefiore Medical Center (October 4, 2018)
This very relevant and highly challenging question brings to mind Osler’s quote: "Medicine is a science of uncertainty and an art in probability". How do we ...
At what point (ie 8, 10, 12 weeks or more) would you no longer offer consolidation durvalumab?
New answer by Medical Oncologist at Fox Chase Cancer Center (December 11, 2018)
The PACIFIC study, which evaluated the use of durvalamab after completion of chemotherapy and radiation (both sequential and concurrent) is a landmark trial demonstrating impr...
Since the randomized phase II data from Gomez et al presented at ASTRO 2018 showed a survival benefit, is there concern about randomizing patients to ...
New answer by Radiation Oncologist at University of Texas Southwestern Medical Center (December 6, 2018)
On behalf of @Puneeth Iyengar, MD, PhD and @Daniel R. Gomez, MDThis question is very important and goes towards the question of equipoise from the perspective of the physician...