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Safety monitoring of two and four-weekly adjuvant durvalumab for patients with stage III NSCLC: implications for the COVID-19 pandemic and beyond.
Joshi, Kroopa; Muhith, Abdul; Obeid, Mariam; Milner-Watts, Charlotte; Yousaf, Nadia; Popat, Sanjay; Davidson, Michael; Bhosle, Jaishree; O'Brien, Mary; Minchom, Anna.
  • Joshi K; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
  • Muhith A; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
  • Obeid M; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
  • Milner-Watts C; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
  • Yousaf N; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.
  • Popat S; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.
  • Davidson M; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
  • Bhosle J; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
  • O'Brien M; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
  • Minchom A; Lung Unit, Department of Medical Oncology, The Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK; The Drug Development Unit, The Royal Marsden Hospital/Institute of Cancer Research, Downs Road, Sutton, SM2 5PT, UK. Electronic address: anna.minchom@icr.ac.uk.
Lung Cancer ; 156: 147-150, 2021 06.
Article in English | MEDLINE | ID: covidwho-1219424
Semantic information from SemMedBD (by NLM)
1. durvalumab TREATS Stage III Lung Non-Small Cell Cancer AJCC v7
Subject
durvalumab
Predicate
TREATS
Object
Stage III Lung Non-Small Cell Cancer AJCC v7
2. Stage III Lung Non-Small Cell Cancer AJCC v7 PROCESS_OF Patients
Subject
Stage III Lung Non-Small Cell Cancer AJCC v7
Predicate
PROCESS_OF
Object
Patients
3. durvalumab TREATS Patients
Subject
durvalumab
Predicate
TREATS
Object
Patients
4. Biological Response Modifiers TREATS Stage III Lung Non-Small Cell Cancer AJCC v7
Subject
Biological Response Modifiers
Predicate
TREATS
Object
Stage III Lung Non-Small Cell Cancer AJCC v7
5. Biological Response Modifiers TREATS Patients
Subject
Biological Response Modifiers
Predicate
TREATS
Object
Patients
6. Concurrent Chemoradiotherapy TREATS Stage III Lung Non-Small Cell Cancer AJCC v7
Subject
Concurrent Chemoradiotherapy
Predicate
TREATS
Object
Stage III Lung Non-Small Cell Cancer AJCC v7
7. durvalumab ADMINISTERED_TO Patients
Subject
durvalumab
Predicate
ADMINISTERED_TO
Object
Patients
8. Patients LOCATION_OF IMPACT gene
Subject
Patients
Predicate
LOCATION_OF
Object
IMPACT gene
9. Lymphom PROCESS_OF 1
Subject
Lymphom
Predicate
PROCESS_OF
Object
1
10. Toxic effect PROCESS_OF Patients
Subject
Toxic effect
Predicate
PROCESS_OF
Object
Patients
11. durvalumab TREATS Stage III Lung Non-Small Cell Cancer AJCC v7
Subject
durvalumab
Predicate
TREATS
Object
Stage III Lung Non-Small Cell Cancer AJCC v7
12. Stage III Lung Non-Small Cell Cancer AJCC v7 PROCESS_OF Patients
Subject
Stage III Lung Non-Small Cell Cancer AJCC v7
Predicate
PROCESS_OF
Object
Patients
13. durvalumab TREATS Patients
Subject
durvalumab
Predicate
TREATS
Object
Patients
14. Biological Response Modifiers TREATS Stage III Lung Non-Small Cell Cancer AJCC v7
Subject
Biological Response Modifiers
Predicate
TREATS
Object
Stage III Lung Non-Small Cell Cancer AJCC v7
15. Biological Response Modifiers TREATS Patients
Subject
Biological Response Modifiers
Predicate
TREATS
Object
Patients
16. Concurrent Chemoradiotherapy TREATS Stage III Lung Non-Small Cell Cancer AJCC v7
Subject
Concurrent Chemoradiotherapy
Predicate
TREATS
Object
Stage III Lung Non-Small Cell Cancer AJCC v7
17. durvalumab ADMINISTERED_TO Patients
Subject
durvalumab
Predicate
ADMINISTERED_TO
Object
Patients
18. Patients LOCATION_OF IMPACT gene
Subject
Patients
Predicate
LOCATION_OF
Object
IMPACT gene
19. Lymphoma, Large-Cell, Follicular PROCESS_OF Patients
Subject
Lymphoma, Large-Cell, Follicular
Predicate
PROCESS_OF
Object
Patients
20. Toxic effect PROCESS_OF Patients
Subject
Toxic effect
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
Durvalumab is the first approved adjuvant immunotherapy agent for patients with stage III NSCLC treated with concurrent chemoradiotherapy and is associated with improved overall survival. In order to minimise the number of hospital visits for patients receiving durvalumab during the COVID-19 pandemic we implemented 4-weekly (20 mg/kg) durvalumab in place of 2-weekly infusions at The Royal Marsden Hospital. We assessed the potential impact of the safety of a 4-weekly schedule in patients receiving adjuvant durvalumab. We carried out a retrospective study of 40 patients treated with 2-weekly and 4-weekly infusions of durvalumab prior to and during the COVID-19 pandemic. Clinical documentation was analysed from 216 consultations across 40 patients receiving 2-weekly durvalumab and 66 consultations of 14 patients who switched from 2-weekly to 4-weekly durvalumab during the COVID-19 pandemic. In patients receiving 2-weekly durvalumab, the rate of grade 3 and 4 toxicities was 15 % compared to 7% in patients receiving 4-weekly durvalumab. Pre-existing autoimmune disease was considered a risk factor for the development of grade 3 or 4 toxicities. We did not observe any difference in the rate of grade 1 and 2 toxicities between the two groups. Our findings support the use of 4-weekly durvalumab during the COVID-19 pandemic and beyond, obviating the need for 2-weekly face-to-face consultations and blood tests, relevant given the current pandemic and the need to re-structure cancer services to minimise patient hospital visits and exposure to SARS-CoV-2.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Lung Neoplasms Type of study: Observational study / Randomized controlled trials / Risk factors Limits: Humans Language: English Journal: Lung Cancer Journal subject: Neoplasms Year: 2021 Document Type: Article Affiliation country: J.lungcan.2021.04.021

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Lung Neoplasms Type of study: Observational study / Randomized controlled trials / Risk factors Limits: Humans Language: English Journal: Lung Cancer Journal subject: Neoplasms Year: 2021 Document Type: Article Affiliation country: J.lungcan.2021.04.021