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Vol.60 No.7 contents | Japanese/English |
![]() | Full Text of PDF (277K) Article in Japanese |
- Original Article -
Factors Influencing Decision-making in Relation to the Administration of Durvalumab After Chemoradiotherapy (TOPGAN2020-01)
Ryo Ariyasu1, Ken Uchibori1, Hisashi Tanaka2, Eisaku Miyauchi3, Yosuke Kawashima4, Fumiyoshi Ohyanagi5, Atsushi Horiike6, Toshio Sakatani7, Masafumi Saiki8, Yuichi Tambo9, Azusa Tanimoto10, Tomoaki Sonoda11, Junji Koyama12, Takeshi Uenami13, Keita Kudo14, Yuko Tsuchiya15, Makoto Nishio11Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan, 2Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Japan, 3Department of Respiratory Medicine, Tohoku University Hospital, Japan, 4Department of Pulmonary Medicine, Sendai Kousei Hospital, Japan, 5Division of Pulmonary Medicine, Clinical Department of Internal Medicine, Jichi Medical University Saitama Medical Center, Japan, 6Division of Medical Oncology, Department of Medicine, Showa University School of Medicine, Japan, 7Division of Respirology, NTT Medical Center Tokyo, Japan, 8Department of Internal Medicine II, University of Yamanashi Faculty of Medicine, Japan, 9Department of Respiratory Medicine, 10Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan, 11Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan, 12Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan, 13Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Japan, 14Department of Medical Oncology and Respiratory Medicine, National Hospital Organization Osaka Minami Medical Center, Japan, 15Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Japan
Objective. In clinical practice, durvalumab has been used as a standard maintenance treatment after chemoradiotherapy (CRT) for locally advanced non-small cell lung cancer (NSCLC). However, it is unknown as to how often practitioners avoid using durvalumab. The present study aimed to analyze the factors that influence decision-making in relation to the administration of durvalumab. Methods. We retrospectively analyzed the treatment of locally advanced NSCLC in 12 hospitals with lung cancer specialists. We evaluated patients with NSCLC who were treated with CRT from May 2018 to December 2019 and compared the characteristics between patients who received durvalumab and those who did not. We also conducted a questionnaire-based survey to determine the reasons for avoiding durvalumab. Results. Among 199 patients who received CRT, durvalumab was administered to 169 patients (84.9%). The median age of the patients in the non-administration group was significantly higher than that in the administration group (70 vs. 67 years, p=0.0465), and the performance status (PS) ≥1 in the non-administration group was significantly higher than that in the administration group (65.5 vs. 40.4%, p=0.0148). According to the questionnaire responses, durvalumab administration was avoided for the following reasons: adverse events due to CRT (n=7); patient needs (n=5); disease progression (n=4); poor PS (n=3); driver mutation of NSCLC (n=3); and complications of autoimmune disease (n=2). Conclusion. Durvalumab was administered to 84.9% of patients in this study. Each practitioner considered age, PS, adverse events due to CRT, and driver mutations of NSCLC, before prescribing durvalumab.
key words: Non-small cell lung cancer, Durvalumab, Chemoradiotherapy
Received: June 24, 2020
Accepted: September 8, 2020
JJLC 60 (7): 966-971, 2020