2024 World Conference on Lung Cancer (WCLC) - Posters-P1.09A.03 Concurrent Combination of EGFR-TKIs and Thoracic Radiation Therapy for Metastatic Non Small Cell Lung Cancer Patients

P1.09A.03 Concurrent Combination of EGFR-TKIs and Thoracic Radiation Therapy for Metastatic Non Small Cell Lung Cancer Patients

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The study conducted at Toho University Ohashi Medical Center evaluated the concurrent use of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and thoracic radiation therapy in treating metastatic non-small-cell lung cancer (NSCLC) patients with EGFR mutations. The rationale builds on preclinical evidence suggesting EGFR-TKIs have a radiosensitizing effect that could enhance the efficacy of radiation therapy. However, the combination's tolerability and safety were not well understood.<br /><br />This retrospective study involved a review of medical records for patients treated from October 2018 to December 2023, identifying three cases where the combination of EGFR-TKIs and thoracic radiation therapy was used. Among the patients, different mutations were observed, with specific radiation plans implemented, including the use of volumetric modulated arc therapy (VMAT) to minimize damage to healthy organs such as the lungs and heart.<br /><br />Notably, during a follow-up period ranging from 7 to 33 months, no acute or late toxicities like radiation dermatitis, esophagitis, or radiation pneumonitis were observed. Similarly, the median overall survival time was reported as 19 months, with no local recurrences in the irradiated volume areas, indicating effective local control.<br /><br />The study acknowledges the historic association of increased pneumonitis risk with both EGFR-TKIs and radiation therapy when used independently. However, this small cohort study indicated high radiation doses to the lungs did not result in pneumonitis, suggesting potential safety in this combined treatment modality.<br /><br />Though the results are promising, suggesting that EGFR-TKIs combined with thoracic radiation is well-tolerated, the study highlights the need for larger phase II studies to validate safety and efficacy comprehensively, as well as to define correlations between radiation doses and toxicity risks to adjacent organs like lungs, heart, and esophagus.

Asset Subtitle

Masahiro Yoshida

Meta Tag

Speaker Masahiro Yoshida

Topic Metastatic NSCLC – Local Therapies

Keywords

EGFR-TKIs

thoracic radiation therapy

NSCLC

EGFR mutations

radiosensitizing effect

volumetric modulated arc therapy

pneumonitis

local control

safety

phase II studies