Expert Point of View: Johan Vansteenkiste, MD, PhD


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Johan Vansteenkiste, MD, PhD

Johan Vansteenkiste, MD, PhD

FORMAL DISCUSSANT of this trial, Johan Vansteenkiste, MD, PhD, Head of the Respiratory Oncology Unit at the University Hospital KU Leuven, Belgium, was enthusiastic about the PACIFIC trial results. “We had an earthquake of immunotherapy in lung cancer this past year at ESMO. After an earthquake, there is a tsunami of risk vs benefit. I think the results of PACIFIC represent a tsunami of benefit,” he stated. 

“Over the past decade, we have tried to build on standard therapy to improve outcomes for these patients, but all strategies failed. In this study, the progression-free survival difference is strong and clinically relevant,” Dr. Vansteenkiste continued. 

In discussing safety, he said, “There was more toxicity with durvalumab, but in general it was mild. The most important thing many of us were anxious about [with durvalumab] was pneumonitis.” Pneumonitis of any grade was reported in 33.9% of those who received durvalumab vs 24.8% for those who received placebo, but grade 3 or 4 pneumonitis was reported in only 3.4% vs 2.6%, respectively. 

“This is the first strong interim analysis of progression-free survival in a phase III trial for systemic therapy for stage III NSCLC in decades,” he emphasized. “Overall survival results will have more weight. For sure, we need to follow these data for survival in the curative setting. Three overall survival analyses are planned for PACIFIC,” he told listeners. ■

DISCLOSURE: Dr. Vansteenkiste has received research funding at University Hospital KU Leuven from AstraZeneca, MSD; advisory functions at Apotex, AstraZeneca, Eli-Lilly, MSD, and Novartis and; lectures at AstraZeneca, Boehringer Ingelheim, Eli Lilly, MSD, and Novartis.


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