Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Treatment regimen

Durvalumab after chemoradiotherapy in stage 3 lung cancer (PACIFIC)

One year of consolidation immunotherapy after concurrent chemoradiotherapy

Updated: 28 October 20261 min read2 references

Summary for doctors

  • Unresectable stage 3 non-small cell lung cancer without progression after concurrent chemoradiotherapy [1].
  • Start within 42 days of radiotherapy [1].
  • Pneumonitis (radiation or immune-related) is the most important toxicity.

Dose and schedule

Consolidation durvalumab

Stage 3 lung cancer after chemoradiotherapyCycle length: Every 2 or 4 weeks

Stage 3 lung cancer after chemoradiotherapy

DrugDoseRouteSchedule
Durvalumab10 mg/kg every 2 weeks (or 1500 mg every 4 weeks)IVDay 1
Cycle length
Every 2 or 4 weeks
Duration
Up to 12 months

The PACIFIC dose was 10 mg/kg every 2 weeks [1]; a fixed dose of 1500 mg every 4 weeks was approved later.

Dose source: [2].

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

  • No premedication is needed.
  • In EGFR-mutant patients, consolidation osimertinib is the choice instead of durvalumab.

Monitoring and dose adjustment

  • New cough or dyspnoea: CT scan and assessment for pneumonitis; grade 2: hold and give steroids; TSH, glucose, liver enzymes and creatinine at baseline and every 6 weeks; immune-related toxicity as in the immunotherapy toxicity lesson.

Main evidence

Show detailsHide

PACIFIC: median progression-free survival 16.8 vs 5.6 months with placebo [1], and at 5-year follow-up overall survival remained longer.

Related cancer types

Lung cancer

Treatment regimens (physicians)

Trastuzumab deruxtecan (T-DXd, Enhertu): dose and monitoringCarboplatin, pemetrexed and pembrolizumab (KEYNOTE-189)Carboplatin, paclitaxel and pembrolizumab (KEYNOTE-407)Carboplatin-etoposide with atezolizumab or durvalumab in small cell lung cancerPembrolizumab alone in lung cancer with high PD-L1 (KEYNOTE-024)Osimertinib with pemetrexed and platinum (FLAURA2)Amivantamab with lazertinib (MARIPOSA)Adjuvant alectinib after surgery for ALK-positive lung cancer (ALINA)

Physician tools and lessons

Khorana Score (Cancer-Associated Thrombosis Risk)Should I Be Screened for Lung Cancer? (Pack-Year Calculator)10 cheap steps that save patients' livesManagement of brain metastasesMalignant pleural effusion: drainage, pleurodesis or an indwelling catheter

References

2 references
Show all referencesClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung CancerAntonia SJ, Villegas A, Daniel D, et al · N Engl J Med · 2017;377:1919-1929
    DOIPubMed Back to text: 1 2 3 4
  2. 2
    IMFINZI (DURVALUMAB) — Prescribing InformationAstrazeneca Pharmaceuticals LP · FDA label · 2026
    Source Back to text

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/durvalumab-pacific-consolidation/

Related pages

27 October 2026 FOLFOX (mFOLFOX6): dose, schedule and side effects Dose and schedule of mFOLFOX6 (oxaliplatin 85, leucovorin 400, fluorouracil 400 bolus and 2400 as a 46-hour infusion), length of adjuvant treatment, premedication, neuropathy and dose adjustment. 27 October 2026 CAPOX (XELOX): dose, schedule and side effects Dose and schedule of CAPOX or XELOX (oxaliplatin 130 and capecitabine 1000 twice daily, days 1 to 14), length of adjuvant treatment, renal adjustment and side effects. 27 October 2026 FOLFIRI regimen: dose, schedule and side effects Dose and schedule of FOLFIRI (irinotecan 180, leucovorin 400, fluorouracil 400 bolus and 2400 as a 46-hour infusion), diarrhoea control, UGT1A1 and dose adjustment.