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The following is a summary of “Primary lung tumour stereotactic body radiotherapy followed by concurrent mediastinal chemoradiotherapy and adjuvant immunotherapy for locally advanced non-small-cell lung cancer: a multicentre, single-arm, phase 2 trial,” published in the November 2024 issue of Oncology by Heinzerling et al.

People with locally advanced non-small-cell lung cancer (NSCLC) often experience poor regional control and increased toxicity from the combination of chemotherapy and radiotherapy.  

Researchers conducted a prospective study to evaluate the safety and effectiveness of primary tumor stereotactic body radiotherapy (SBRT) followed by concurrent mediastinal chemoradiotherapy and consolidation immunotherapy for patients with NSCLC.  

They enrolled people aged 18 or older with stage II-III, unresectable NSCLC at 8 centers in North and South Carolina (USA). Participants received SBRT (50–54 Gy in 3 to 5 fractions) to the primary tumor, followed by chemoradiotherapy (up to 60 Gy in 30 fractions) to the lymph nodes with concurrent platinum-based chemotherapy. Durvalumab consolidation immunotherapy was given to participants without disease progression after chemoradiotherapy.  

The results showed a 1-year PFS of 62.7% (90% CI 51.2–73.2; 1-sided P=0.39), with 37 of 59 participants progression-free and alive 1 year after enrollment. The most common grade 3–4 treatment-related side effects were decreased neutrophil count (15%), decreased white blood cell count (8%), and anemia (7%). Serious side effects occurred in 18% of participants, including lung infection (5%), pneumonitis (3%), and febrile neutropenia (3%), 4 people (7%) died from treatment-related causes, including respiratory failure and pneumonitis.  

They concluded that primary tumor SBRT followed by concurrent mediastinal chemoradiotherapy and consolidation immunotherapy was safe and effective for patients with NSCLC, showing favorable outcomes compared to other modern treatments.  

Source: thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00573-4/abstract