Canakinumab (IL-1β blockade) + cCRT and durvalumab consolidation hits 67% 24-mo PFS in unresectable stage III NSCLC

CHORUS (NCT04905316) tested canakinumab, an anti–interleukin-1β monoclonal antibody intended to blunt protumor inflammation, given with concurrent chemoradiotherapy (cCRT) and continued alongside anti–PD-L1 durvalumab consolidation in an open-label, single-arm Phase I/II study in unresectable stage III NSCLC (41 enrolled; 37 treated; prespecified efficacy population n=32). At median follow-up 25 months, 24-month PFS from RT start was 67% (95% CI 52–88) with a prespecified one-sided 90% CI lower bound of 56.5% exceeding a 46% historical benchmark; 12- and 24-month OS were 93% and 73%, and confirmed ORR was 81%. Canakinumab-related grade 3–4 AEs included neutropenia (n=5) and febrile neutropenia (n=1), with pneumonitis (any attribution) in 24% (grade 3: 2/37). For context, PACIFIC established durvalumab consolidation after chemoradiation as standard treatment, reporting approximately 56% progression-free survival at 12 months and 66.3% overall survival at 24 months. CHORUS produced encouraging results, but its 24-month PFS was measured from radiation initiation, whereas PACIFIC measured PFS from randomization after chemoradiation. Differences in patient selection, treatment timing, and study design prevent a direct comparison or any conclusion that adding canakinumab improves outcomes beyond standard chemoradiation and durvalumab.