{ "abstract": "Purpose: Chemoradioimmunotherapy (CRIT) with 60–66 Gy is the standard of care (SoC) for non-small-cell lung cancer (NSCLC) UICC stage III. The aim of this real-world data (RWD) study was to report the long-term impact of Durvalumab and radiation dose escalation on clinical outcomes. Material and Methods: ALLSTAR is a nationwide prospective multicentre registry for NSCLC UICC stage III, in which 12/14 Austrian centres participated (ethics approval number: 1002/2019). The basis for the current analysis is the third data extraction, which was completed on 2 June 2025. Apart from the SoC, alternative dose-fractionation and sequential CRT concepts >66 Gy were also permitted. Durvalumab maintenance treatment for one year was administered at the discretion of the tumour board at each centre. Results: Compared to prior analyses by our group, 40 individuals who completed follow-up (FUP) were added to this final analysis, leading to a total patient population of 228 (156 CRT plus Durvalumab; 72 CRT). In 156 patients, Durvalumab was added to CRT, while 72 received CRT only. The median FUP periods were 41.0 (95%-CI: 36.7–45.4) and 37.8 months (95%-CI: 31.4–44.1) for the Durvalumab and CRT cohort, respectively. Radiation dose escalation combined with Durvalumab treatment was associated with a nominally higher ITC of 37 months (95%-CI: 24.5-not reached) compared with 17.7 months (95%-CI: 14.9-not reached) in patients receiving neither dose escalation nor Durvalumab (N = 135; HR = 0.61; 95%-CI: 0.37–1.006; p-value 0.051). With Durvalumab maintenance, a median PFS of 22.8 months (95%-CI: 19.4–38.3) was observed compared to 16.5 months (95%-CI: 12.6–24.5) without (N = 228; HR = 0.61; 95%-CI: 0.42–0.88; p-value 0.0071). Median OS was 52.6 months (95%-CI: 39.5-not reached) with Durvalumab compared to 27.4 months (95%-CI: 18.7-not reached) without (N = 228; HR = 0.52; 95%-CI: 0.34–0.78; log-rank p-value < 0.002). Median time to death or distant metastasis (TTDM) was 33.3 months (95%-CI: 23.5–45) in the Durvalumab cohort compared to 18.7 months (95%-CI: 14.8-not reached) in the CRT cohort (N = 228; HR = 0.60; 95%-CI: 0.42–0.89; log-rank p-value 0.01). Median time to death or local relapse (TDLR) with Durvalumab was 30.4 months (95%-CI: 23.5–51.1) compared to 17.2 months (95%-CI: 14.8–25.7) without (N = 226; HR = 0.58; 95%-CI: 0.40–0.83; log-rank p-value < 0.003). Conclusion: This final RWD analysis implies both a beneficial effect of high-dose irradiation combined with Durvalumab on ITC and the long-lasting impact of Durvalumab on PFS, OS, TTDM, and TDLR.", "abstract_shown": true, "affiliations": [ "Comprehensive Cancer Centre, Department of Radiation Oncology, Medical University Innsbruck, A-6020 Innsbruck, Austria", "Department of Radiation Oncology, Paracelsus Medical University, A-5020 Salzburg, Austria", "Klinikum Ottakring, A-1160 Vienna, Austria", "Ordensklinikum Linz, A-4010 Linz, Austria", "Comprehensive Cancer Centre, Department of Radiation Oncology, Medical University Vienna, A-1090 Vienna, Austria" ], "article_type": "research article", "arxiv": null, "author_total": 12, "authors": [ { "affs": [ 0 ], "name": "Katharina Hörmandinger", "orcid": "0009-0002-5362-5859" }, { "affs": [ 1 ], "name": "Elvis Ruznic", "orcid": "0000-0001-7686-1008" }, { "affs": [ 2 ], "name": "Marisa Klebermass" }, { "affs": [ 1 ], "name": "Brane Grambozov", "orcid": "0000-0003-2454-7425" }, { "affs": [ 2 ], "name": "Petra Feurstein" }, { "affs": [ 1 ], "name": "Josef Karner" }, { "affs": [ 3 ], "name": "Georg Gruber", "orcid": "0009-0004-8357-5439" }, { "affs": [ 4 ], "name": "Martin Heilmann" }, { "affs": [ 1 ], "name": "Falk Röder" }, { "affs": [ 0 ], "name": "Ute Ganswindt" }, { "affs": [ 0 ], "name": "Danijela Minasch" }, { "affs": [ 1 ], "name": "Franz Zehentmayr", "orcid": "0000-0001-5931-3907" } ], "bibtex": "https://research.draconitic.com/paper/5r9w1dse1ha4e.bib", "cited_by": 0, "doi": "10.3390/cancers18193173", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664182/?tool=EBI", "id": "5r9w1dse1ha4e", "issns": [ "2072-6694" ], "landing_url": "https://europepmc.org/article/PMC/PMC13664182", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2740|Lung Cancer Diagnosis and Treatment" ] ], "openalex": "W7215116021", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664182/pdf/?tool=EBI", "pmcid": "PMC13664182", "pmid": null, "published": "2026-10-01", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/5r9w1dse1ha4e.ris", "sources": [ { "first_seen": "2026-10-30T12:17:31Z", "native_id": "PMC:PMC13664182", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13664182" }, { "first_seen": "2026-10-30T12:19:58Z", "native_id": "10.3390/cancers18193173", "source": "crossref", "url": "https://www.mdpi.com/2072-6694/18/19/3173" } ], "subjects": [ { "field": "medicine", "origin": "issn:2072-6694", "subfield": "oncology" } ], "title": "Durvalumab Plus High-Dose Radiation in NSCLC III: Long-Term Results from the Austrian Radio-Oncological Lung Cancer Study Association Registry (ALLSTAR)", "title_text": "Durvalumab Plus High-Dose Radiation in NSCLC III: Long-Term Results from the Austrian Radio-Oncological Lung Cancer Study Association Registry (ALLSTAR)", "type": "peer-reviewed", "updated_at": "2026-10-30T12:19:58Z", "url": "https://research.draconitic.com/paper/5r9w1dse1ha4e", "venue": "Cancers", "versions": [] }