PACIFIC
Made a year of immunotherapy after chemoradiation the standard for stage III lung cancer, with a survival benefit that held at five years.
713 patients. PFS 16.9 vs 5.6 months; OS HR 0.68; 5-year OS 42.9% vs 33.4%. Established consolidation immunotherapy. Benefit weaker in EGFR-mutant disease, where LAURA (osimertinib) now applies.
Setting
Unresectable stage III NSCLC without progression after chemoradiation: durvalumab 1 year vs placebo
Phase
Phase 3
Sponsor
AstraZeneca
Registry
Headline result
OS HR 0.68; 5-year OS 42.9% vs 33.4%.
Reported
2017
Enrolled
713
Replication
Confirmed by the real-world PACIFIC-R cohort and by GEMSTONE-301 (sugemalimab) in the same setting.
In plain words
What these results mean for people, not percentages
Progression-free survival (BICR)primarysurrogate endpoint
- Median 16.8 vs 5.6 months with Durvalumab compared with Placebo; about 11.2 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 48 percent lower chance of the event at any given time (hazard ratio 0.52, likely range 0.42 to 0.65).
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
Overall survival at 5 yearsprimarysurvival endpoint
- 42.9 vs 33.4 out of 100 alive at 5 years with Durvalumab compared with Placebo; 9.5 more per 100.
- Roughly one extra person helped for every 11 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- Put another way, the treated group had about 28 percent lower chance of the event at any given time (hazard ratio 0.72, likely range 0.59 to 0.89).
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
Be careful
- These results apply to the people the trial enrolled: Unresectable stage III NSCLC without progression after chemoradiation: durvalumab 1 year vs placebo. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
713 participants enrolled.
Progression-free survival (BICR)primary
HR 0.52 (0.42–0.65) · p <0.001
Durvalumab
16.8 mo
Placebo
5.6 mo
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival (BICR)primary | Durvalumab | 476 | 16.8 months | 0.52 (0.42–0.65) | <0.001 | link |
| Placebo | 237 | 5.6 months | ||||
| Overall survival at 5 yearsprimary | Durvalumab | — | 42.9% | 0.72 (0.59–0.89) | — | link |
| Placebo | — | 33.4% |
Replication
Confirmed by the real-world PACIFIC-R cohort and by GEMSTONE-301 (sugemalimab) in the same setting.