{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:46:57Z","timestamp":1784544417443,"version":"3.55.0"},"reference-count":42,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Concurrent chemoradiotherapy (CRT) followed by maintenance treatment with the PD-L1 inhibitor durvalumab is a new standard of care for inoperable stage III NSCLC. The present study compares the oncological outcome of patients treated with CRT to those treated with CRT and durvalumab (CRT-IO) in the real-world setting. The analysis was performed based on the retro- and prospectively collected data of 144 consecutive inoperable stage III NSCLC patients treated between 2011\u20132020. Local-regional-progression-free-survival (LRPFS\u2014defined as progression in the mediastinum, hilum and\/or supraclavicular region at both sites and the involved lung), progression-free survival (PFS), and overall survival (OS) were evaluated from the last day of thoracic radiotherapy (TRT). Median follow-up for the entire cohort was 33.1 months (range: 6.3\u2013111.8) and median overall survival was 27.2 (95% CI: 19.5\u201334.9) months. In the CRT-IO cohort after a median follow-up of 20.9 (range: 6.3\u201327.4) months, median PFS was not reached, LRPFS (p = 0.002), PFS (p = 0.018), and OS (p = 0.005) were significantly improved vs. the historical cohort of conventional CRT patients. After propensity-score matching (PSM) analysis with age, gender, histology, tumor volume, and treatment mode, and exact matching for T-and N-stage, 22 CRT-IO patients were matched 1:2 to 44 CRT patients. Twelve-month LRPFS, PFS, and OS rates in the CRT-IO vs. CRT cohort were 78.9 vs. 45.5% (p = 0.002), 60.0 vs. 31.8% (p = 0.007), and 100 vs. 70.5% (p = 0.003), respectively. This real-world analysis demonstrated that durvalumab after CRT led to significant improvement of local-regional control, PFS, and OS in PD-L1 expressing inoperable stage III NSCLC patients compared to a historical cohort.<\/jats:p>","DOI":"10.3390\/cancers13071613","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T10:24:33Z","timestamp":1617186273000},"page":"1613","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Durvalumab after Chemoradiotherapy for PD-L1 Expressing Inoperable Stage III NSCLC Leads to Significant Improvement of Local-Regional Control and Overall Survival in the Real-World Setting"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1473-1202","authenticated-orcid":false,"given":"Julian","family":"Taugner","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University Hospital, LMU Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"K\u00e4smann","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital, LMU Munich, 81377 Munich, Germany"},{"name":"Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Center for Lung Research (DZL), 81377 Munich, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-1398","authenticated-orcid":false,"given":"Chukwuka","family":"Eze","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital, LMU Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Tufman","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine and Thoracic Oncology, Department of Internal Medicine V, Thoracic Oncology Centre Munich, LMU Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Reinmuth","sequence":"additional","affiliation":[{"name":"Asklepios Kliniken GmbH, Asklepios Fachkliniken Muenchen, 82131 Gauting, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Duell","sequence":"additional","affiliation":[{"name":"Asklepios Kliniken GmbH, Asklepios Fachkliniken Muenchen, 82131 Gauting, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Belka","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital, LMU Munich, 81377 Munich, Germany"},{"name":"Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Center for Lung Research (DZL), 81377 Munich, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farkhad","family":"Manapov","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital, LMU Munich, 81377 Munich, Germany"},{"name":"Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Center for Lung Research (DZL), 81377 Munich, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Munich, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.21037\/tlcr.2019.09.19","article-title":"Survival score to characterize prognosis in inoperable stage III NSCLC after chemoradiotherapy","volume":"8","author":"Taugner","year":"2019","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13014-019-1453-3","article-title":"Prognostic value of PD-L1 expression on tumor cells combined with CD8+ TIL density in patients with locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy","volume":"15","author":"Gennen","year":"2020","journal-title":"Radiat. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s00066-017-1229-3","article-title":"Analysis of primary tumor metabolic volume during chemoradiotherapy in locally advanced non-small cell lung cancer","volume":"194","author":"Roengvoraphoj","year":"2018","journal-title":"Strahlenther. Onkol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1378\/chest.122.3.1037","article-title":"Prognostic factors in non-small cell lung cancer: A decade of progress","volume":"122","author":"Brundage","year":"2002","journal-title":"Chest"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1038\/bjc.2017.232","article-title":"Lung cancer prognostic index: A risk score to predict overall survival after the diagnosis of non-small-cell lung cancer","volume":"117","author":"Alexander","year":"2017","journal-title":"Br. J. Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1038\/nrc.2017.84","article-title":"Understanding and targeting resistance mechanisms in NSCLC","volume":"17","author":"Rotow","year":"2017","journal-title":"Nat. Rev. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5306\/wjco.v8.i1.1","article-title":"Therapeutic management options for stage III non-small cell lung cancer","volume":"8","author":"Yoon","year":"2017","journal-title":"World J. Clin. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1038\/nrclinonc.2015.90","article-title":"Refining the treatment of NSCLC according to histological and mo-lecular subtypes","volume":"12","author":"Thomas","year":"2015","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13014-020-01590-8","article-title":"Pattern-of-failure and salvage treatment analysis after chemoradiotherapy for inoperable stage III non-small cell lung cancer","volume":"15","author":"Taugner","year":"2020","journal-title":"Radiat. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5077","DOI":"10.21873\/anticanres.13701","article-title":"Performance Status and Its Changes Predict Outcome for Patients with Inoperable Stage III NSCLC Undergoing Multimodal Treatment","volume":"39","author":"Taugner","year":"2019","journal-title":"Anticancer Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00066-017-1221-y","article-title":"Predictive and prognostic value of tumor volume and its changes during radical radiotherapy of stage III non-small cell lung cancer","volume":"194","author":"Niyazi","year":"2018","journal-title":"Strahlenther. Onkol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2181","DOI":"10.1200\/JCO.2009.26.2543","article-title":"Meta-Analysis of Concomitant Versus Sequential Radiochemotherapy in Locally Advanced Non\u2013Small-Cell Lung Cancer","volume":"28","author":"Rolland","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2393","DOI":"10.1002\/(SICI)1097-0142(19960601)77:11<2393::AID-CNCR31>3.0.CO;2-Q","article-title":"Patterns of disease failure after trimodality therapy of nonsmall cell lung carcinoma pathologic stage IIIA (N2). Analysis of Cancer and Leukemia Group B Protocol 8935","volume":"77","author":"Kumar","year":"1996","journal-title":"Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3389\/fonc.2011.00047","article-title":"Radiation Dose Escalation in Stage III Non-Small-Cell Lung Cancer","volume":"1","author":"Terakedis","year":"2011","journal-title":"Front. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1093\/jnci\/88.17.1210","article-title":"Improved Survival in Stage III Non-Small-Cell Lung Cancer: Seven-Year Follow-up of Cancer and Leukemia Group B (CALGB) 8433 Trial","volume":"88","author":"Dillman","year":"1996","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/S1470-2045(14)71207-0","article-title":"Standard-dose versus high-dose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with stage IIIA or IIIB non-small-cell lung cancer (RTOG 0617): A randomised, two-by-two factorial phase 3 study","volume":"16","author":"Bradley","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1200\/JCO.19.01162","article-title":"Long-Term Results of NRG Oncology RTOG 0617: Standard-Versus High-Dose Chemoradiotherapy with or without Cetuximab for Unresectable Stage III non\u2013small-cell lung cancer","volume":"38","author":"Bradley","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1093\/jnci\/djr325","article-title":"Sequential vs Concurrent Chemoradiation for Stage III non-small cell lung cancer: Randomized Phase III Trial RTOG 9410","volume":"103","author":"Curran","year":"2011","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1056\/NEJMoa1709937","article-title":"Durvalumab after Chemoradiotherapy in Stage III Non\u2013Small-Cell Lung Cancer","volume":"377","author":"Antonia","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1056\/NEJMoa1809697","article-title":"Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC","volume":"379","author":"Antonia","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.jtho.2019.10.002","article-title":"Three-Year Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC\u2014Update from PACIFIC","volume":"15","author":"Gray","year":"2020","journal-title":"J. Thorac. Oncol."},{"key":"ref_22","first-page":"1","article-title":"Chemoradioimmunotherapy of inoperable stage III non-small cell lung cancer: Immunological rationale and current clinical trials establishing a novel multimodal strategy","volume":"15","author":"Eze","year":"2020","journal-title":"Radiat. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.radonc.2019.11.015","article-title":"Utilization and factors precluding the initiation of consolidative durvalumab in unresectable stage III non-small cell lung cancer","volume":"144","author":"Shaverdian","year":"2020","journal-title":"Radiother. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.resinv.2019.03.011","article-title":"Patients with unresectable stage III non-small cell lung cancer eligible to receive consolidation therapy with durvalumab in clinical practice based on PACIFIC study criteria","volume":"57","author":"Sakaguchi","year":"2019","journal-title":"Respir. Investig."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00280-019-03885-4","article-title":"Ineligibility for the PACIFIC trial in unresectable stage III non-small cell lung cancer patients","volume":"84","author":"Hosoya","year":"2019","journal-title":"Cancer Chemother. Pharmacol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4622","DOI":"10.1002\/cam4.3113","article-title":"Radiation pneumonitis in lung cancer patients treated with chemoradiation plus durvalumab","volume":"9","author":"Shaverdian","year":"2020","journal-title":"Cancer Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S370","DOI":"10.1016\/j.jtho.2018.08.350","article-title":"MA05.02 PACIFIC Subgroup Analysis: Pneumonitis in Stage III, Unresectable NSCLCPatients Treated with Durvalumab vs. Placebo After CRT.J","volume":"13","author":"Vansteenkiste","year":"2018","journal-title":"Thorac. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"v592","DOI":"10.1093\/annonc\/mdz259.002","article-title":"Efficacy of durvalumab in patients with stage III NSCLC who experience pneumonitis (PACIFIC)","volume":"30","author":"Vansteenkiste","year":"2019","journal-title":"Ann. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.radonc.2020.04.047","article-title":"Clinical outcomes, local\u2013regional control and the role for metastasis-directed therapies in stage III non-small cell lung cancers treated with chemoradiation and durvalumab","volume":"149","author":"Offin","year":"2020","journal-title":"Radiother. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.lungcan.2020.05.035","article-title":"Real world data of durvalumab consolidation after chemoradiotherapy in stage III non-small-cell lung cancer","volume":"146","author":"Jung","year":"2020","journal-title":"Lung Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1111\/1759-7714.13426","article-title":"Consolidation treatment of durvalumab after chemoradiation in real-world patients with stage III unresectable non-small cell lung cancer","volume":"11","author":"Chu","year":"2020","journal-title":"Thorac. Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.radonc.2018.02.023","article-title":"ESTRO ACROP guidelines for target volume definition in the treatment of locally advanced non-small cell lung cancer","volume":"127","author":"Nestle","year":"2018","journal-title":"Radiother. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1287\/opre.36.1.93","article-title":"Relaxation methods for minimum cost ordinary and generalized network flow problems","volume":"36","author":"Bertsekas","year":"1988","journal-title":"Oper. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1198\/016214504000000647","article-title":"Full matching in an observational study of coaching for the SAT","volume":"99","author":"Hansen","year":"2004","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v042.i08","article-title":"MatchIt: Nonparametric preprocessing for parametric causal inference","volume":"42","author":"Ho","year":"2011","journal-title":"J. Stat. Softw."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1093\/pan\/mpl013","article-title":"Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference","volume":"15","author":"Ho","year":"2007","journal-title":"Polit. Anal."},{"key":"ref_37","unstructured":"Thoemmes, F. (2020, December 20). Propensity Score Matching in SPSS. Available online: https:\/\/arxiv.org\/pdf\/1201.6385."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/s00066-016-0941-8","article-title":"GILT\u2014A randomised phase III study of oral vinorelbine and cisplatin with concomitant radiotherapy followed by either consolidation therapy with oral vinorelbine and cisplatin or best supportive care alone in stage III non-small cell lung cancer","volume":"192","author":"Flentje","year":"2016","journal-title":"Strahlenther. Onkol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1097\/JTO.0b013e3182429682","article-title":"Defining local-regional control and its importance in locally advanced non-small cell lung carcinoma","volume":"7","author":"Machtay","year":"2012","journal-title":"J. Thorac. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.ejca.2020.10.008","article-title":"Durvalumab therapy following chemoradiation compared with a historical cohort treated with chemoradiation alone in patients with stage III non\u2013small cell lung cancer: A real-world multicentre study","volume":"142","author":"Desilets","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/1759-7714.13764","article-title":"Effect of durvalumab on local control after concurrent chemoradiotherapy for locally advanced non-small cell lung cancer in comparison with chemoradiotherapy alone","volume":"12","author":"Abe","year":"2021","journal-title":"Thorac. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e172","DOI":"10.1016\/j.prro.2020.09.010","article-title":"Who benefits the most from adjuvant durvalumab after chemoradiotherapy for non-small cell lung cancer? An exploratory analysis","volume":"11","author":"Ohri","year":"2021","journal-title":"Pract. Radiat. Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/7\/1613\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:33:16Z","timestamp":1760362396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/7\/1613"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,31]]},"references-count":42,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["cancers13071613"],"URL":"https:\/\/doi.org\/10.3390\/cancers13071613","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,31]]}}}