2023 World Conference on Lung Cancer (Posters)-P2.03. Treatment-related Pneumonitis in Non-small Cell Lung Cancer Treated with Thoracic RT plus TKI: A Systematic Review and Meta-Analysis

P2.03. Treatment-related Pneumonitis in Non-small Cell Lung Cancer Treated with Thoracic RT plus TKI: A Systematic Review and Meta-Analysis - PDF(Abstract)

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A systematic review and meta-analysis was conducted to evaluate the risk of treatment-related pneumonitis (TRP) in patients with non-small cell lung cancer (NSCLC) treated with thoracic radiotherapy (TRT) plus tyrosine kinase inhibitors (TKIs). The study aimed to provide an overview of the existing literature and determine the incidence of severe TRP in this treatment approach. The analysis included 33 relevant studies with a total of 925 patients.<br /><br />The results showed that the overall incidence of grade 3 and 4 TRP was 3.9% (95% CI, 1.8 to 6.7%). Fatal pneumonitis was rare, with an overall rate of 0.1% (95% CI, 0.0% to 0.4%). Subgroup analyses showed that patients receiving curative (chemo)radiotherapy had a higher proportion of severe TRP (5.2%, 95% CI, 3.2% to 7.5%) compared to those receiving local radical or palliative TRT (2.1%, 95% CI, 0.1% to 6.7%). Patients receiving concurrent TKI and TRT had a higher overall TRP rate (6.4%, 95% CI, 3.3% to 10.4%) compared to those with time intervals between TKI and thoracic RT (0.7%, 95% CI, 0.0% to 4.2%).<br /><br />The meta-analysis concluded that the combination of TKIs with thoracic RT had a generally acceptable risk of grade 3 or 4 TRP and a rare incidence of fatal pneumonitis. It was considered to be safe, especially for local ablative or palliative RT combined with first-generation EGFR TKIs. However, the risk of severe TRP was increased in patients receiving concurrent TKI and RT without time intervals. The data on osimertinib, ALK-TKIs, and related pneumonitis in this combined setting were limited and require further investigation.<br /><br />In summary, this study provides valuable insights into the risk of TRP in NSCLC patients treated with thoracic RT plus TKIs. The findings can help clinicians make informed decisions regarding treatment strategies for metastatic NSCLC.

Asset Subtitle

Yinnan Meng

Meta Tag

Speaker Yinnan Meng

Topic Metastatic NSCLC: Local Therapies

Keywords

systematic review

meta-analysis

treatment-related pneumonitis

non-small cell lung cancer

thoracic radiotherapy

tyrosine kinase inhibitors

incidence of severe TRP

grade 3 and 4 TRP

fatal pneumonitis

chemo-radiotherapy