{
  "abstract": "Background One-third of patients with non-small cell lung cancer (NSCLC) are diagnosed with stage III, locally advanced disease. Older adults with cancer often have more complex health and supportive care needs compared to their younger patients. The aim of this study was to assess outcomes and healthcare utilization among older patients with stage III NSCLC who were treated with concurrent chemoradiation followed by durvalumab at our hospitalMethods We conducted a retrospective cohort study at a single institution involving patients over 65 years old with stage III NSCLC who were treated with chemoradiation followed by durvalumab. Data collection included baseline characteristics, treatment protocols, emergency room (ER) visits, hospitalizations, treatment-related toxicity, and utilization of home health care servicesResults A total of 60 patients were included in the study, with a median age of 72 years; 50% (30) were female. Among the patients, 38% (23) were current smokers and 48% (29) were former smokers. EGFR mutations were present in 13% (8) of patients. PD-L1 expression was <1% in 81% (49) of patients, 1–49% in 6% (4), and ≥50% in 10% (6).The most common chemotherapy was a carboplatin histology-based doublet in 33 (55%) of patients, most commonly using a 3-week regimen. Only 50% (30) of patients completed all durvalumab treatment cycles. The primary reasons for durvalumab discontinuation were disease progression (58% - 17 patients) and pneumonitis (40% - 12 patients).The most common durvalumab-related toxicities were pneumonitis (43% - 13 patients) and hypothyroidism (40% - 12 patients). There were 26 (43%) patients with emergency room visits and 35% (21 patients) hospitalizations during treatment. There were 5 patients that used the home care service use. Median progression-free survival (PFS) was 26.2 (CI 8.7 -43.7) months. Intrathoracic recurrence occurred in 47% of patients and extrathoracic in 29%, including 22% with brain metastases. Recurrence during durvalumab treatment was observed in 21% of patients, with the most common site of progression being intrathoracic (76%). OS was 51 months (CI 40-61)Conclusions In this real-world cohort of older adults with stage III NSCLC treated with chemoradiation followed by durvalumab, treatment completion rates were low, and toxicity—particularly pneumonitis—was a frequent cause of discontinuation. There were high rates of ER visits and hospitalizations, while home care service use was low. These findings underscore the need for personalized treatment strategies and enhanced supportive care in this vulnerable population.",
  "authors": [
    {
      "affiliations": [
        "Sunnybrook Health Sciences Centre, Toronto, ON, Canada"
      ],
      "name": "Malu Viter Da Rosa Barbosa"
    },
    {
      "affiliations": [
        "Hospital Sirio Libanes, Brasilia, Distrito Federal, Brazil"
      ],
      "name": "Tatyanni Paula Araujo Vargas"
    },
    {
      "affiliations": [
        "Sunnybrook Health Sciences Centre, Toronto, ON, Canada"
      ],
      "name": "Labkhand Maghamianzadeh"
    },
    {
      "affiliations": [
        "Sunnybrook Health Sciences Centre, Toronto, ON, Canada"
      ],
      "name": "Khloe Campos"
    },
    {
      "affiliations": [
        "Sunnybrook Health Sciences Centre, Toronto, ON, Canada"
      ],
      "name": "Ines Menjak"
    }
  ],
  "title": "1069 Real-world experience with durvalumab amongst older patients",
  "uid": "6944e741-ddfa-512f-a124-3897d8918f9b"
}