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PACIFIC
About the Trial
PACIFIC randomized 713 patients with unresectable stage III non small cell lung cancer, stable after chemoradiotherapy, to consolidation durvalumab or placebo. The PD L1 antibody extended median progression free survival from 5.6 to about 17 months, with estimated 5 year survival of about 43 versus 33 percent. Stage III disease, a wasteland of post chemoradiation uncertainty for decades, gained a standard of care almost overnight. The PACIFIC regimen became the template for consolidation immunotherapy. The trial illustrated how a well timed maintenance strategy can convert modest chemoradiation outcomes into durable disease control in a historically stubborn setting.
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