TY - JOUR 
A1 - Mielgo Rubio, Xabier
AU - Rojo, Federico
AU - Mezquita Pérez, Laura
AU - Casas, Francesc
AU - Wals, Amadeo
AU - Juan, Manel
AU - Aguado, Carlos
AU - Garde Noguera, Javier
AU - Vicente, David
AU - Couñago Lorenzo, Felipe
T1 - Deep diving in the PACIFIC: Practical issues in stage III non-small cell lung cancer to avoid shipwreck
Y1 - 2020
SN - 2218-4333
UR - http://hdl.handle.net/11268/10623
AB - After publication of the PACIFIC trial results, immune checkpoint inhibitor-based immunotherapy was included in the treatment algorithm of locally advanced non-small cell lung cancer (NSCLC). The PACIFIC trial demonstrated that 12 mo of durvalumab consolidation therapy after radical-intent platinum doublet chemotherapy with concomitant radiotherapy improved both progression-free survival and overall survival in patients with unresectable stage III NSCLC. This is the first treatment in decades to successfully improve survival in this clinical setting, with manageable toxicity and without deterioration in quality of life. The integration of durvalumab in the management of locally advanced NSCLC accentuates the need for multidisciplinary, coordinated decision-making among lung cancer specialists, bringing new challenges and controversies as well as important changes in clinical work routines. The aim of the present article is to review-from a practical, multidisciplinary perspective-the findings and implications of the PACIFIC trial. We evaluate the immunobiological basis of durvalumab as well as practical aspects related to programmed cell death ligand 1 determination. In addition, we comprehensively assess the efficacy and toxicity data from the PACIFIC trial and discuss the controversies and practical aspects of incorporating durvalumab into routine clinical practice. Finally, we discuss unresolved questions and future challenges. In short, the present document aims to provide clinicians with a practical guide for the application of the PACIFIC regimen in routine clinical practice.
KW - Neoplasias pulmonares
KW - Anticuerpos monoclonales
KW - Cáncer
KW - Submarinismo
KW - Inmunología
LA - eng
ER -