Updated phase 2 data showed a 60% ORR and 86% CNS ORR with frontline silevertinib in non-classical EGFR-mutant NSCLC; FDA discussion supported a phase 3 trial in 2027.
|Videos|February 22, 2019
Stage IIIB Unresectable NSCLC After Chemoradiotherapy
Stage IIIB Unresectable NSCLC After Chemoradiotherapy
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Case: A 72-Year-Old Female With Stage IIIB NSCLC
Initial presentation
- A 72-year-old woman presented with a 17-lb weight loss and dyspnea
- PMH: HTN and hyperlipidemia
- PSH: Laparoscopic cholecystectomy
- SH: Smoked 3 packs/day for 30 years; Quit 5 years ago
- PE: Unremarkable
Clinical workup
- Imaging:
- Chest x-ray showed a left hilar mass with a middle lobe collapse
- CT scan of the chest/abdomen/pelvis revealed a 4.9 x 5.4 cm left upper lobe mass with bilateral hilar and mediastinal lymphadenopathy
- CT abdomen/pelvis negative for metastatic disease
- PET/CT confirmed activity in the lung and lymph nodes
- MRI of the brain was negative for metastatic disease
- CT-guided biopsy of the left lung mass revealed a differentiated invasive squamous cell carcinoma
- Molecular testing: PD-L1 20%
- Staging: T2bN3M0IIIB
- ECOG PS 1
Treatment
- Concurrent chemoradiation with weekly carboplatin-paclitaxel
- Imaging 6 weeks after completion showed response in the lung and lymph nodes
- Durvalumab consolidation: 4 cycles with continued tumor control on imaging
- Developed dyspnea and cough after 8 cycles
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