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.
13 affiliations
- 1Department of Proliferative Diseases, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland.
- 2Institute of Mechatronics and Information Systems, Lodz University of Technology, Lodz, Poland.
- 3Department of Radiotherapy, Holy Cross Cancer Center, Kielce, Poland.
- 4Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
- 5Department of Radiotherapy, Affidea Nu-Med Center of Oncological Diagnostics and Therapy, Zamość, Poland.
- 6II Clinic of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
- 7Department of General and Oncological Pulmonology, Medical University of Lodz, Lodz, Poland.
- 8Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, Poland.
- 9Ludwik Rydygier Memorial Specialized Hospital, Krakow, Poland.
- 10Department of Nephrology and Internal Medicine, Centre of Postgraduate Medical Education, Warsaw, Poland.
- 11Voivodeship Combined Hospital, Skierniewice, Poland.
- 12Department of External Beam Radiotherapy, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland.
- 13Department of Radiotherapy, Medical University of Lodz, Lodz, Poland.
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.
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BibTeX
@article{lisikhabib2026functional,
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.}},
author = {Maja Lisik-Habib and Krzysztof Smółka and Rafał Stando and Grzegorz Chmielewski and Mateusz Bilski and Katarzyna Galwas and Damian Tworek and Mirosława Puskulluoglu and Agnieszka Roman and Małgorzata Terlecka-Maciejewska and Jacek Fijuth and Łukasz Kuncman},
journal = {Translational lung cancer research},
year = {2026},
month = sep,
doi = {10.21037/tlcr-2026-0567},
url = {https://europepmc.org/article/MED/42999612},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - 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.
AU - Maja Lisik-Habib
AU - Krzysztof Smółka
AU - Rafał Stando
AU - Grzegorz Chmielewski
AU - Mateusz Bilski
AU - Katarzyna Galwas
AU - Damian Tworek
AU - Mirosława Puskulluoglu
AU - Agnieszka Roman
AU - Małgorzata Terlecka-Maciejewska
AU - Jacek Fijuth
AU - Łukasz Kuncman
PY - 2026
DA - 2026/09/28
JO - Translational lung cancer research
DO - 10.21037/tlcr-2026-0567
UR - https://europepmc.org/article/MED/42999612
AB - 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.
SN - 2218-6751
SN - 2226-4477
ER -