Jyoti S. Mayadev, MD, indicated that durvalumab (Imfinzi) plus chemotherapy resulted in low rates of high-grade late-onset toxicities in the phase 3 CALLA trial, which may be due in part to the quality of the technology employed during the study.
During the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting, CancerNetwork® spoke with Jyoti S. Mayadev, MD, about early- and late-onset toxicities observed with durvalumab (Infinzi) and chemoradiotherapy (CRT), as well as placebo and CRT in patients with high-risk locally advanced cervical cancer in the phase 3 CALLA trial (NCT03830866). In particular, Mayadev, a radiation oncologist and professor of radiation medicine and applied sciences at the University of California, San Diego School of Medicine, explained how few high-grade late-onset toxicities occurred in the experimental arm.
We were really looking at toxicities in terms of how they might be potentially impacted by durvalumab. We found that the grade 3 and above acute-onset toxicity is about 30% related to radiation therapy. This can include diarrhea, neutropenia, and anemia. In terms of the late toxicities, we were actually very surprised. We have very detailed data in terms of quality, follow-up, and data capture. We found that roughly 1% and 2% within both arms had a grade 3 and higher late toxicity. This includes gastrointestinal [GI] toxicities, which we're always concerned about and talk to patients about in terms of rectal bleeding or fistula. These rates are extremely low, and we can attribute it to the quality of the technology on this trial.
Mayadev JS, Rong, Y, Toita T, et al. Durvalumab in combination with chemoradiotherapy (CRT) in locally advanced cervical cancer (LACC): radiotherapy (RT) delivery and subgroup analyses from CALLA. Presented at 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting; October 23-26, 2022; San Antonio, TX; LBA 03. Accessed October 27, 2022.