The following is a summary of “Immunochemotherapy alone or immunochemotherapy plus subsequent locoregional radiotherapy in de novo metastatic nasopharyngeal carcinoma,” published in the December 2023 issue of Oncology by Liu, et al.

Through the use of immunotherapy, researchers, for a study, sought to examine the function that locoregional radiation plays in the treatment of de novo metastatic nasopharyngeal cancer (NPC), as well as to evaluate the advantages of radiotherapy and to identify individuals who may benefit from these treatments. A total of 273 patients with histopathology-confirmed de novo metastatic non-small cell lung cancer who were scheduled to receive immunochemotherapy with or without following intensity-modulated radiotherapy were included in the study between May 2017 and October 2021. 

For the study, they compared the two groups regarding progression-free survival (PFS), overall survival (OS), and safety. A subgroup analysis was carried out, and a scoring model was constructed to determine which individuals would be appropriate for radiation therapy. The immunochemotherapy alone was administered to 34.8% of the patients, whereas the immunochemotherapy combined with later radiation was administered to 65.2%. When compared to immunochemotherapy alone, the combination treatment group had better progression-free survival (PFS) at one year (80.6% against 65.1%) and overall survival (OS) (98.3% versus 89.5%). Both multivariate and propensity score-matched analyses consistently found that this advantage was present. 

Patients with oligometastases, Epstein-Barr virus (EBV) DNA levels lower than 20,200 copies/mL, and patients who had experienced a total or partial recurrence after immunochemotherapy also benefited better from this treatment. Following the combination treatment, the patient had anemia of grade 3 or 4, as well as toxicity due to radiation. With acceptable toxicity, immunochemotherapy combined with subsequent locoregional radiation was able to prolong life in patients with de novo metastatic non-small cell lung cancer. It may be possible to ease personalized care by using a scoring model that considers parameters such as oligometastases, the amount of EBV DNA, and the response following immunochemotherapy.

Source: sciencedirect.com/science/article/abs/pii/S1368837523002798