---
title: "EGFR Mutation Linked to Higher Out-of-Field Recurrence After Chemoradiotherapy Plus Durvalumab in"
id: "pubmed-42674719"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674719"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674719/"
doi: "10.21873/anticanres.18361"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# EGFR Mutation Linked to Higher Out-of-Field Recurrence After Chemoradiotherapy Plus Durvalumab in
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674719
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674719/)
- **DOI:** [10.21873/anticanres.18361](https://doi.org/10.21873%2Fanticanres.18361)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective analysis assessed 83 patients with locally advanced unresectable non‑small cell lung cancer (NSCLC) treated with chemoradiotherapy followed by durvalumab consolidation (the PACIFIC regimen). Ten patients had tumors with **EGFR** mutations. - Median follow-up was 26.6 months. The study compared progression‑free survival (PFS), overall survival (OS), and cumulative incidences of in‑field recurrence (IFR) and out‑of‑field recurrence (OFR) between EGFR mutation‑positive and mutation‑negative groups. - The 2‑year PFS was 23% (95% CI 7–78%) in the **EGFR mutation‑positive** group versus 53% (95% CI 42–66%) in the EGFR‑negative group (p = 0.15). - The 2‑year cumulative incidence of **OFR** was significantly higher in the EGFR‑positive group: 77% (95% CI 49–100%) versus 26% (95% CI 16–37%) in the EGFR‑negative group (hazard ratio 2.90, 95% CI 1.29–6.51; p = 0.01). - Exploratory multivariate analysis identified **EGFR mutation positivity**, Eastern Cooperative Oncology Group performance status (ECOG) 2–4, and PD‑L1 expression <1% as significantly associated with increased risk of OFR. - No significant differences were reported between groups for IFR, OS, or adverse events. - Authors conclude that while in‑field control and safety were comparable, EGFR mutation positivity was associated with higher OFR, underscoring limitations of durvalumab consolidation in this subgroup and supporting consideration of alternative systemic approaches such as osimertinib. - The source reports these findings from a retrospective cohort; details on certain study design elements and broader limitations were not reported in the abstract.
## Clinical Analysis & Structured Key Points
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r1707em@jichi.ac.jp."), [Yukiko Fukuda](https://pubmed.ncbi.nlm.nih.gov/?term=Fukuda+Y&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-3 "Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan."), [Machi Nakagawa](https://pubmed.ncbi.nlm.nih.gov/?term=Nakagawa+M&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Kazunari Ogawa](https://pubmed.ncbi.nlm.nih.gov/?term=Ogawa+K&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Michiko Nakamura](https://pubmed.ncbi.nlm.nih.gov/?term=Nakamura+M&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Daisuke Irie](https://pubmed.ncbi.nlm.nih.gov/?term=Irie+D&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Satoru Takahashi](https://pubmed.ncbi.nlm.nih.gov/?term=Takahashi+S&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Masahiro Kawahara](https://pubmed.ncbi.nlm.nih.gov/?term=Kawahara+M&cauthor_id=42674719)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-3 "Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan."), [Keiko Akahane](https://pubmed.ncbi.nlm.nih.gov/?term=Akahane+K&cauthor_id=42674719)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-3 "Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan."), [Makoto Maemondo](https://pubmed.ncbi.nlm.nih.gov/?term=Maemondo+M&cauthor_id=42674719)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-4 "Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan."), [Yasuhiro Yamaguchi](https://pubmed.ncbi.nlm.nih.gov/?term=Yamaguchi+Y&cauthor_id=42674719)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-5 "Department of Respiratory, Jichi Medical University Saitama Medical Center, Saitama, Japan."), [Harushi Mori](https://pubmed.ncbi.nlm.nih.gov/?term=Mori+H&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Katsuyuki Shirai](https://pubmed.ncbi.nlm.nih.gov/?term=Shirai+K&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#full-view-affiliation-3 "Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan.") Affiliations Expand ### Affiliations * 1 Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan; r1707em@jichi.ac.jp. * 2 Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan. * 3 Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan. * 4 Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan. * 5 Department of Respiratory, Jichi Medical University Saitama Medical Center, Saitama, Japan. * PMID: **42674719** * DOI: [ 10.21873/anticanres.18361 ](https://doi.org/10.21873/anticanres.18361) Item in Clipboard # Association Between _EGFR_ Mutation Status and Out-of-field Recurrence in Locally Advanced Unresectable Non-small Cell Lung Cancer Treated With Chemoradiotherapy and Durvalumab Consolidation Masashi Endo et al. Anticancer Res. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Anticancer Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anticancer+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Anticancer+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674719/) . 2026 Sep;46(9):5155-5167. doi: 10.21873/anticanres.18361. ### Authors [Masashi Endo](https://pubmed.ncbi.nlm.nih.gov/?term=Endo+M&cauthor_id=42674719)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-1 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan; r1707em@jichi.ac.jp."), [Yukiko Fukuda](https://pubmed.ncbi.nlm.nih.gov/?term=Fukuda+Y&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-3 "Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan."), [Machi Nakagawa](https://pubmed.ncbi.nlm.nih.gov/?term=Nakagawa+M&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Kazunari Ogawa](https://pubmed.ncbi.nlm.nih.gov/?term=Ogawa+K&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Michiko Nakamura](https://pubmed.ncbi.nlm.nih.gov/?term=Nakamura+M&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Daisuke Irie](https://pubmed.ncbi.nlm.nih.gov/?term=Irie+D&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Satoru Takahashi](https://pubmed.ncbi.nlm.nih.gov/?term=Takahashi+S&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Masahiro Kawahara](https://pubmed.ncbi.nlm.nih.gov/?term=Kawahara+M&cauthor_id=42674719)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-3 "Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan."), [Keiko Akahane](https://pubmed.ncbi.nlm.nih.gov/?term=Akahane+K&cauthor_id=42674719)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-3 "Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan."), [Makoto Maemondo](https://pubmed.ncbi.nlm.nih.gov/?term=Maemondo+M&cauthor_id=42674719)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-4 "Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan."), [Yasuhiro Yamaguchi](https://pubmed.ncbi.nlm.nih.gov/?term=Yamaguchi+Y&cauthor_id=42674719)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-5 "Department of Respiratory, Jichi Medical University Saitama Medical Center, Saitama, Japan."), [Harushi Mori](https://pubmed.ncbi.nlm.nih.gov/?term=Mori+H&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan."), [Katsuyuki Shirai](https://pubmed.ncbi.nlm.nih.gov/?term=Shirai+K&cauthor_id=42674719)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-2 "Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674719/#short-view-affiliation-3 "Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan.") ### Affiliations * 1 Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan; r1707em@jichi.ac.jp. * 2 Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan. * 3 Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan. * 4 Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan. * 5 Department of Respiratory, Jichi Medical University Saitama Medical Center, Saitama, Japan. * PMID: **42674719** * DOI: [ 10.21873/anticanres.18361 ](https://doi.org/10.21873/anticanres.18361) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background/aim:** The efficacy of durvalumab consolidation therapy after chemoradiotherapy (PACIFIC regimen) for patients with epidermal growth factor receptor (_EGFR_) mutation-positive locally advanced unresectable non-small cell lung cancer (NSCLC) remains unclear. Additionally, data on failure patterns, including in-field recurrence (IFR) and out-of-field recurrence (OFR), are limited. **Patients and methods:** In this retrospective study, 83 patients with locally advanced unresectable NSCLC treated with the PACIFIC regimen were analyzed. Of them, 10 patients had tumors harboring _EGFR_ mutations. Progression-free survival (PFS), overall survival (OS), and the cumulative incidences of IFR and OFR were evaluated. **Results:** The median follow-up time was 26.6 months. The 2-year PFS rate was 23% [95% confidence interval (CI)=7-78%] in the _EGFR_ mutation-positive group and 53% (95%CI=42-66%) in the _EGFR_ mutation-negative group (_p_ =0.15). The 2-year cumulative incidence of OFR was significantly higher in the _EGFR_ mutation-positive group (77%, 95% CI=49-100%) than in the _EGFR_ mutation-negative group (26%, 95%CI=16-37%) (hazard ratio=2.90, 95%CI=1.29-6.51, _p_ =0.01). On exploratory multivariate analysis, _EGFR_ mutation positivity, Eastern Cooperative Oncology Group performance status 2-4, and PD-L1 expression <1% were significantly associated with OFR. No significant differences in IFR, OS, and adverse events were observed between the groups. **Conclusion:** Although IFR and safety profiles were comparable between the two groups, EGFR mutation positivity was associated with a higher incidence of OFR. These exploratory findings highlight the limitations of durvalumab consolidation and support the shift toward alternative systemic strategies, such as osimertinib, in patients with EGFR mutation-positive locally advanced unresectable NSCLC. **Keywords:** Chemoradiotherapy; durvalumab; epidermal growth factor receptor; non-small cell lung cancer. Copyright © 2026 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved. 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