{
  "abstract": "Disease progression after durvalumab consolidation is frequent in unresectable stage III non-small cell lung cancer (NSCLC), but the prognostic relevance of functional and nutritional status at first progression is insufficiently characterized. We evaluated their associations with post-progression overall survival (OS) and receipt of subsequent systemic therapy. This five-center retrospective cohort study included patients with histologically confirmed unresectable stage III NSCLC who received definitive concurrent chemoradiotherapy (cCRT) followed by durvalumab and developed first documented disease progression. Clinical data were extracted using standardized case report forms. Eastern Cooperative Oncology Group (ECOG) performance status at progression, longitudinal body weight change from chemotherapy initiation to the last durvalumab administration, and post-progression treatment were evaluated. OS was calculated from first progression. The multivariable Cox model used complete cases; no imputation was performed. Sixty patients were included, and 34 deaths occurred. ECOG performance status at progression was available for 59 patients; ECOG ≥2 was observed in 26 (44.1%) and was associated with shorter median OS (8.3 vs. 21.2 months; P=0.01). In the complete-case multivariable model (n=59; 33 deaths), ECOG ≥2 [hazard ratio (HR) 2.34, 95% confidence interval (CI): 1.12-4.89; P=0.02], body weight loss ≥3% (HR 2.37, 95% CI: 1.10-5.07; P=0.03), and progression within 6 months of durvalumab initiation (HR 2.16, 95% CI: 1.07-4.35; P=0.03) were associated with worse OS. Forty-seven patients (78.3%) received subsequent systemic therapy. At first progression after cCRT and durvalumab, impaired performance status was associated with poor post-progression survival. An exploratory, cohort-derived 3% weight-loss threshold and early progression also identified higher-risk patients but require external validation. Systematic functional and nutritional reassessment at progression may support individualized treatment planning, multidisciplinary supportive care, and realistic discussion of prognosis.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Proliferative Diseases, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland.",
    "Institute of Mechatronics and Information Systems, Lodz University of Technology, Lodz, Poland.",
    "Department of Radiotherapy, Holy Cross Cancer Center, Kielce, Poland.",
    "Collegium Medicum, Jan Kochanowski University, Kielce, Poland.",
    "Department of Radiotherapy, Affidea Nu-Med Center of Oncological Diagnostics and Therapy, Zamość, Poland.",
    "II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.",
    "Department of General and Oncological Pulmonology, Medical University of Lodz, Lodz, Poland.",
    "Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, Poland.",
    "Ludwik Rydygier Memorial Specialized Hospital, Krakow, Poland.",
    "Department of Nephrology and Internal Medicine, Centre of Postgraduate Medical Education, Warsaw, Poland.",
    "Voivodeship Combined Hospital, Skierniewice, Poland.",
    "Department of External Beam Radiotherapy, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland.",
    "Department of Radiotherapy, Medical University of Lodz, Lodz, Poland."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Maja Lisik-Habib"
    },
    {
      "affs": [
        1
      ],
      "name": "Krzysztof Smółka"
    },
    {
      "affs": [
        2
      ],
      "name": "Rafał Stando"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Grzegorz Chmielewski"
    },
    {
      "affs": [
        4
      ],
      "name": "Mateusz Bilski"
    },
    {
      "affs": [
        5
      ],
      "name": "Katarzyna Galwas"
    },
    {
      "affs": [
        6
      ],
      "name": "Damian Tworek"
    },
    {
      "affs": [
        7
      ],
      "name": "Mirosława Puskulluoglu"
    },
    {
      "affs": [
        8
      ],
      "name": "Agnieszka Roman"
    },
    {
      "affs": [
        9,
        10
      ],
      "name": "Małgorzata Terlecka-Maciejewska"
    },
    {
      "affs": [
        11,
        12
      ],
      "name": "Jacek Fijuth"
    },
    {
      "affs": [
        11,
        12
      ],
      "name": "Łukasz Kuncman"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dk17kqhxrcfm8.bib",
  "cited_by": 0,
  "doi": "10.21037/tlcr-2026-0567",
  "fulltext_url": "https://europepmc.org/articles/PMC13743445",
  "id": "dk17kqhxrcfm8",
  "issns": [
    "2218-6751",
    "2226-4477"
  ],
  "landing_url": "https://europepmc.org/article/MED/42999612",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Lung Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223309594",
  "pdf_url": "https://europepmc.org/articles/PMC13743445?pdf=render",
  "pmcid": "PMC13743445",
  "pmid": "42999612",
  "published": "2026-09-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dk17kqhxrcfm8.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42999612",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42999612"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2730|Lung Cancer Research Studies",
      "subfield": "oncology"
    }
  ],
  "title": "Functional decline at progression after durvalumab in stage III non-small cell lung cancer: prognostic impact and treatment patterns in a multicenter retrospective cohort study.",
  "title_text": "Functional decline at progression after durvalumab in stage III non-small cell lung cancer: prognostic impact and treatment patterns in a multicenter retrospective cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/dk17kqhxrcfm8",
  "venue": "Translational lung cancer research",
  "versions": []
}