Durvalumab has been a breakthrough for stage 3 NSCLC given DFS and OS in Pacific study and recent FDA approval for nonresectable stage 3. But there were statistically 0 Asian female never smokers in the Pacific study (possibly/probably by design).
One concern is, with I think Atlantic study and IMpower 150 studies showing EGFR+ Stage IV never smokers not statistically benefitting from Durvalumab, why would my wife still go ahead with Durvalumab for a year when there is not evidence supporting her to benefit from the treatment and go thru side effect risks, etc...
Durvalumab treatment looks to be contraindicated being given to EGFR+ Stage 3 nonresectable by Dr Kelly here:
I can tell this is going to be a difficult decision for my wife to make after chemo/rad finishes soon (couple weeks).
What I am hoping for is if anyone can point me toward evidence or studies relating to Durvalumab monotherapy helping EGFR+ Adeno never smokers, including Asian ethnicity and female would be a big bonus.
I've found a little to support possible Erlotinib post concurrent treatment but nothing on using Durvalumab for EGFR+ never smoker female Asian.
Statistically, the Pacific trial had 6% EGFR+, 9% never smoker (already making it about 0.5% of group). Then throw in female at 30% of group and I think 27% Asian... think that equates to less than 0.05% of study group as Asian female never smoker EGFR+.
Since there were less than 1,000 people in the study, it shows there was not even one Asian female EGFR+ never smoker in the study. This really makes me scratch my head why a chemo oncologist would push forward with the idea of one year on Durvalumab given lack of evidence to support it. What am I missing?
REALLY appreciate all the help, especially moderators. Wish I could bend Dr West's ear for direction :).
Take care, thank you so much for any help with info/studies!