This study states that Historically, the prognosis for patients with metastatic non–small-cell lung cancer (NSCLC) has been poor, with 5-year survival of approximately 6%.1 However, the introduction of immune checkpoint inhibitors that target the programmed cell death protein 1 (PD-1) receptor or its ligand (PD-L1) has significantly improved outcomes, prolonging both overall survival (OS) and progression-free survival (PFS). Durvalumab is a selective, high-affinity human immunoglobulin G1 monoclonal antibody that blocks PD-L1 binding to PD-1 and CD80.2 It is approved globally for the treatment of patients with unresectable, stage III NSCLC whose disease has not progressed following platinum-based chemoradiotherapy.3,  4,  5 Clinical activity of durvalumab has also been demonstrated in patients with advanced NSCLC, either alone or in combination with the anti-cytotoxic T-lymphocyte-associated antigen-4 agent tremelimumab.6,  7,  8

The phase 3 MYSTIC study (NCT02453282) was a global, randomized, open-label trial comparing first-line durvalumab with or without tremelimumab versus platinum-based chemotherapy in patients with metastatic NSCLC.9 MYSTIC did not meet its primary endpoints of improved OS or PFS with durvalumab + tremelimumab versus chemotherapy in patients with tumor cell (TC) PD-L1 expression ≥ 25%. However, durvalumab alone versus chemotherapy was associated with a numerically reduced risk of death (hazard ratio [HR] = 0.76; 97.54% confidence interval [CI], 0.56-1.02; P = .04).

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