Durvalumab after Chemoradiotherapy in Limited-Stage Small-Cell Lung Cancer

Cheng, Ying; Spigel, David R.; Cho, Byoung Chul; Laktionov, Konstantin K.; Fang, Jian; Chen, Yuanbin; Zenke, Yoshitaka; Lee, Ki Hyeong; Wang, Qiming; Navarro, Alejandro; Bernabe, Reyes; Buchmeier, Eva Lotte; Chang, John Wen-Cheng; Shiraishi, Yoshimasa; Goksu, Sema Sezgin; Badzio, Andrzej; Shi, Anhui; Daniel, Davey B.; Hoa, Nguyen Thi Thai; Zemanova, Milada; Mann, Helen; Gowda, Hema; Jiang, Haiyi; Senan, Suresh

doi:10.1056/nejmoa2404873

N Engl J Med

2024

DOI: 10.1056/nejmoa2404873

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Durvalumab after Chemoradiotherapy in Limited-Stage Small-Cell Lung Cancer

Ying Cheng,

David R. Spigel,

Byoung Chul Cho

et al.

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Cited by 20 publications

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Combination Immunotherapy With Radiotherapy in Non‐Small Cell Lung Cancer: A Review of Evidence

Burr,

Johnson,

Carmicheal

et al. 2024

Cancer Medicine

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BackgroundRadiotherapy plays a fundamental role in the treatment of patients with all stages of non‐small‐cell lung cancer (NSCLC). The emergence of immune checkpoint inhibitors (ICIs) has transformed the standard of care in these patients. The use of ICIs is increasingly utilized in the definitive setting as an adjunct to chemoradiotherapy or surgery and remains a vital component in the treatment of metastatic disease. Despite improvements in patient survival, the use of immunotherapy as monotherapy has shown limited overall response rates with susceptibility to resistance. Radiotherapy has been identified as a viable option to enhance the response rate to ICI and improve outcomes in NSCLC.MethodsWe queried the English PubMed database utilizing variably combined search items including “radiation,” “chemoradiation,” “immune checkpoint,” “immunotherapy,” “stereotactic body radiotherapy,” and “non‐small‐cell lung”. We additionally searched various acceptable alternative terms for similar keywords such as “radiotherapy” in place of “radiation.” These results were subsequently curated for relevance and impact on current treatment paradigms.ResultsIn this review, we discuss preclinical and clinical studies relating to combinatorial use of immunotherapy and radiation in NSCLC. These studies are presented in the context of early‐stage, operable stage III, unresectable stage III, and metastatic disease. The majority of the data illustrate promising results regarding the additive or synergistic effects of radiation and immunotherapy with a suggestion that the timing of these treatment modalities is crucial to optimizing outcomes.ConclusionWhile there is now evidence regarding the favorable interplay between radiation and immunotherapy in NSCLC, there remain multiple unanswered questions which are expected to be addressed in ongoing clinical trials.

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Combination Immunotherapy With Radiotherapy in Non‐Small Cell Lung Cancer: A Review of Evidence

Burr,

Johnson,

Carmicheal

et al. 2024

Cancer Medicine

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Quality of life outcomes in patients participating in the CALGB 30610 trial (CALGB 70702): Alliance

Ganti,

Fruth,

Rimner

et al. 2024

Cancer

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BackgroundCALGB 30610 trial demonstrated that once daily thoracic radiotherapy (TRT) was not superior compared to standard twice daily TRT, in patients with limited stage small cell lung cancer. Quality of life outcomes may help oncologists decide the best treatment approach.MethodsA total of 417 patients on CALGB 30610 participated in the quality‐of‐life substudy (CALGB 70702), which included the FACT Trial Outcome Index‐Lung Cancer (FACT‐L TOI), FACT‐Esophageal Cancer (FACT‐E) Eating and Swallowing Indices, ECOG Acute Esophagitis Scale, Hospital Anxiety and Depression Scale (HADS), difficulty swallowing, EQ‐5D, and treatment convenience assessment at baseline, 3, 5, 7, 12, 26, and 52 weeks after starting TRT. Primary end points included FACT‐L TOI and FACT‐E at 12 weeks. Mean changes from baseline were compared between arms using general linear mixed models.ResultsFACT‐L worsening was more in the twice daily arm at week 3 (–1.0 vs. –7.0). FACT‐L TOI worsening was less at week 3 (–2.9 vs. –7.6) and greater at week 12 (–7.6 vs. –2.8) in the once daily arm. The once daily arm had a lower EQ‐5D index worsening at 3 weeks (0.01 vs. –0.02). Increase in acute esophagitis score (1.06 vs. 2.89; p < .001) and difficulty swallowing (0.39 vs. 1.14) were greater in the twice daily arm at week 3. A total of 74.5% of patients on the once daily arm felt that treatment was convenient, compared to 67% of patients in the twice daily arm (p = .03).ConclusionsThe once daily arm had better quality‐of‐life scores earlier during treatment and was perceived to be more convenient.

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Time to rethink platinum choices in the era of immunotherapy in lung cancer

Harris,

Taflin,

Chitkara

et al. 2024

Annals of Oncology

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Durvalumab after Chemoradiotherapy in Limited-Stage Small-Cell Lung Cancer

Cited by 20 publications

References 38 publications

Combination Immunotherapy With Radiotherapy in Non‐Small Cell Lung Cancer: A Review of Evidence

Combination Immunotherapy With Radiotherapy in Non‐Small Cell Lung Cancer: A Review of Evidence

Quality of life outcomes in patients participating in the CALGB 30610 trial (CALGB 70702): Alliance

Time to rethink platinum choices in the era of immunotherapy in lung cancer

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