Would you resume durvalumab after several month hiatus due to IO unrelated medical comorbidities that has since resolved?

This is a challenging question and it is hard to know what the right answer is. If the patient's ECOG PS is good, Durvalumab was well tolerated for the most part, and the IO unrelated medical co-morbidities are now under control, I would consider re-initiation of Durvalumab. I would balance risk and benefit with the patient and discuss things at length. It does depend as well on the length of the hiatus. If it is 6 months, I likely would not. If it is 2-3, I would consider.

As Drs. Jalal and Gadgeel have mentioned, individualized decision-making is most important. While the question notes that the reason for holding durvalumab was unrelated to immunotherapy, the patient did have a medical problem that required holding therapy for "several months", which suggests a major medical issue. It also might be a bit presumptuous for us to think that we always know what may be related or unrelated to immunotherapy as the potential side-effects are multifaceted and unpredicta...

I agree with @Dr. First Last. Just two datasets to consider- 1. There was a suggestion in PACIFIC that patients who initiated therapy 2 weeks after completion of chemo+RT had greater benefit than patients who completed therapy at 6 weeks. The speculation is there is interaction between effects of chemo+RT on the tumor and efficacy of durvalumab. It is not clear if with passing of time this interaction ceases to occur, minimizing the effects of durva. 2. There are retrospective studies that have ...