Durvalumab versus sugemalimab as consolidation therapy after definitive chemoradiotherapy for unresectable stage III non–small-cell lung cancer: a real-world comparative effectiveness study

Durvalumab is the standard consolidation therapy after definitive chemoradiotherapy (dCRT) for unresectable stage III non–small-cell lung cancer (NSCLC), whereas sugemalimab has also been increasingly adopted in clinical practice. However, direct comparative evidence between these two programmed death-ligand 1 (PD-L1) inhibitors remains lacking. This study compared the effectiveness and safety of durvalumab and sugemalimab as consolidation therapy after dCRT in a real-world cohort. We retrospectively analyzed 116 patients with unresectable stage III NSCLC who received durvalumab ( n = 62) or sugemalimab ( n = 54) after definitive CRT at a single institution. The primary endpoint was overall survival (OS); secondary endpoints included real-world progression-free survival (rwPFS), treatment duration, and safety. Stabilized inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics. At a median follow-up of 27.1 months, 63 rwPFS events and 35 deaths occurred. After IPTW adjustment, no statistically significant differences were observed in OS (HR, 0.69; 95% CI, 0.30–1.61; P = 0.392) or rwPFS (HR, 1.12; 95% CI, 0.67–1.88; P = 0.654). Immunotherapy type was not an independent prognostic factor. Median treatment duration was 12.0 months with durvalumab and 21.6 months with sugemalimab. Any-grade pneumonitis occurred in 51.6% and 38.9%, respectively ( P = 0.170), and grade ≥ 3 pneumonitis was uncommon (1.6% vs. 1.9%). No treatment-related deaths occurred. In this IPTW-adjusted real-world study, no statistically significant differences in survival outcomes were observed between durvalumab and sugemalimab; both had acceptable safety profiles after dCRT for unresectable stage III NSCLC. Not applicable.