{"entity":{"id":"pacific","kind":"trial","name":"PACIFIC","aka":[],"tldr":"Made a year of immunotherapy after chemoradiation the standard for stage III lung cancer, with a survival benefit that held at five years.","summary":"PACIFIC, trial NCT02125461 sponsored by AstraZeneca and reported in 2017, made a year of durvalumab after chemoradiation the standard for unresectable stage III non-small-cell lung cancer. It randomised 713 patients without progression after chemoradiation to durvalumab or placebo, met its primary progression-free survival endpoint by blinded review, and went on to show an overall survival benefit that held at five years, establishing consolidation immunotherapy as a concept. Its findings were reproduced in the real-world PACIFIC-R cohort and by GEMSTONE-301 with sugemalimab, and OnCo links it to Scott J. Antonia and to the chemoradiation and consolidation therapy terms. The benefit was weaker in EGFR-mutant disease, where LAURA now applies, and whether shorter or biomarker-guided consolidation could match a full year is the open question. Durvalumab has its own page.","status":"positive","asOf":"2026-09-06","links":[{"label":"ClinicalTrials.gov NCT02125461","url":"https://clinicaltrials.gov/study/NCT02125461"}],"tags":[],"related":[],"cancers":["nsclc","stage-iii-unresectable-nsclc"],"sections":[],"technologies":["imrt-igrt","checkpoint-inhibitor"],"targets":[],"drugs":["durvalumab"],"companies":["astrazeneca"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["scott-antonia"],"bottlenecks":[],"keyPapers":["paper-pacific-nejm-2017","paper-pacific-n-engl-j-med-2018-update"],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT02125461","phase":"3","setting":"Unresectable stage III NSCLC without progression after chemoradiation: durvalumab 1 year vs placebo","sponsor":"AstraZeneca","result":"OS HR 0.68; 5-year OS 42.9% vs 33.4%.","started":"2014-05-07","startedType":"actual","yearReported":2017,"enrolled":713,"enrolledBasis":"registry","outcomes":[{"endpoint":"Progression-free survival (BICR)","primary":true,"unit":"months","arms":[{"name":"Durvalumab","n":476,"value":16.8},{"name":"Placebo","n":237,"value":5.6}],"hr":0.52,"ci":[0.42,0.65],"p":"<0.001","source":"https://www.nejm.org/doi/full/10.1056/NEJMoa1709937"},{"endpoint":"Overall survival at 5 years","primary":true,"unit":"%","arms":[{"name":"Durvalumab","value":42.9},{"name":"Placebo","value":33.4}],"hr":0.72,"ci":[0.59,0.89],"source":"https://ascopubs.org/doi/10.1200/JCO.21.01308"}],"replication":"Confirmed by the real-world PACIFIC-R cohort and by GEMSTONE-301 (sugemalimab) in the same setting."},"route":"/trials/pacific/","neighbours":{"cancer":[{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"stage-iii-unresectable-nsclc","kind":"cancer","name":"Unresectable stage III non-small-cell lung cancer","route":"/cancers/stage-iii-unresectable-nsclc/"}],"technology":[{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"}],"drug":[{"id":"durvalumab","kind":"drug","name":"Durvalumab","route":"/drugs/durvalumab/"}],"company":[{"id":"astrazeneca","kind":"company","name":"AstraZeneca","route":"/companies/astrazeneca/"}],"person":[{"id":"scott-antonia","kind":"person","name":"Scott J. Antonia","route":"/people/scott-antonia/"}],"paper":[{"id":"paper-spigel-pacific-five-year-survival-jco-2022","kind":"paper","name":"Five-year survival outcomes from the PACIFIC trial: durvalumab after chemoradiotherapy in stage III non-small-cell lung cancer","route":"/key-papers/paper-spigel-pacific-five-year-survival-jco-2022/"},{"id":"paper-pacific-n-engl-j-med-2018-update","kind":"paper","name":"Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC","route":"/key-papers/paper-pacific-n-engl-j-med-2018-update/"},{"id":"paper-pacific-nejm-2017","kind":"paper","name":"PACIFIC: a year of durvalumab after chemoradiotherapy for stage III lung cancer","route":"/key-papers/paper-pacific-nejm-2017/"}],"trial":[{"id":"gemstone-301","kind":"trial","name":"GEMSTONE-301","route":"/trials/gemstone-301/"}],"term":[{"id":"chemoradiation","kind":"term","name":"Chemoradiation (chemoradiotherapy, CRT)","route":"/terms/chemoradiation/"},{"id":"consolidation-therapy","kind":"term","name":"Consolidation therapy","route":"/terms/consolidation-therapy/"},{"id":"kaplan-meier-curve","kind":"term","name":"Kaplan-Meier curve, censoring and proportional hazards","route":"/terms/kaplan-meier-curve/"}],"roadmap":[{"id":"radiation-roadmap","kind":"roadmap","name":"Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH","route":"/roadmaps/radiation-roadmap/"}]}}