Prognosis and Adverse Effect in Non-small Cell Lung Cancer Patients Receiving Durvalumab Immunotherapy Following Concurrent Chemoradiotherapy

초록

Prognosis and Adverse Effect in Non-small Cell Lung Cancer Patients Receiving Durvalumab Immunotherapy Following Concurrent Chemoradiotherapy Yunseon Choi, Jun Hyeok Lim, Hunjung Kim, Jaesung Heo Inha University Hospital, Ajou University Hospital Purpose: We analyzed the prognosis of patients with non-small cell lung cancer (NSCLC) treated with an immune checkpoint inhibitor after concurrent chemoradiotherapy (CCRT). We also examined whether body mass index (BMI) influenced prognosis. Methods: We analyzed 46 patients treated for stage II-IV NSCLC at Inha University Hospital from October 2020 to December 2024. These patients received CCRT consisting of taxol/carboplatin or cisplatin-based chemotherapy combined with conventional fraction radiotherapy at 2 Gy/day for a total of 48-60 Gy, followed by durvalumab (PD-L1 inhibitor). Results: Median follow-up was 19.7 months (range 3.2-70.5). The median BMI was 24.0 (range 14.2-39.0). Twenty-one patients (45.7%) progressed during follow-up. Fourteen patients (30.4%) died during follow-up; six of these deaths were related to pneumonia, not progression. Overall survival (OS) at 1 year was 85.9% and at 2 years was 67.0% in all patients. Progression-free survival (PFS) was 84.2% at 1 year and 51.4% at 2 years. Obesity was not a factor influencing the death rate or progression rate. Patients with a BMI ≤18.5 (n=8) did not have a higher probability of progression (p=0.788). However, the mortality rate was significantly higher in patients with a BMI ≤18.5 (p=0.003). The probability of death related to adverse effects from pneumonia was higher in these thin patients (p=0.001). Conclusion: Patients with NSCLC who received immunotherapy after CCRT showed favorable survival outcomes. However, caution is warranted as underweight patients have a higher probability of death related to pneumonia. Keywords: non-small cell lung cancer, concurrent chemoradiotherapy, immune checkpoint inhibitor, body mass index, pneumonia