Retrospective analysis of impact of bone metastasis in stage IV NSCLC treated with durvalumab and tremelimumab with or without chemotherapy

The multinational phase 2 CCTG BR.34 trial randomized 301 patients with metastatic non-small cell lung cancer (mNSCLC) to first-line durvalumab plus tremelimumab (DT) with or without doublet chemotherapy (CT). The primary analysis of the study found that addition of CT to DT did not improve overall survival. Retrospective analysis of the trial evaluating the impact of bone metastasis has now been published. Baseline bone metastasis was present in 129 patients and absent in 172 patients. Presence of liver and brain metastasis did not differ significantly between both groups. The median overall survival as well as the median progression-free survival was worse in the group with bone metastasis, as was the overall response rate (29.5% versus 45.9%; OR 0.52; p=0.01). This impact of bone metastasis on outcomes was seen in both arms of the trial. The authors conclude that among mNSCLC patients receiving DT with or without CT, presence of bone metastasis was associated with worse outcomes.