WCLC 2025 - Posters & ePosters-EP.08.21 Sequential Radiotherapy Following Induction Immunochemotherapy/Chemotherapy for Unresectable Stage III Non-Small Cell Lung Cancer

EP.08.21 Sequential Radiotherapy Following Induction Immunochemotherapy/Chemotherapy for Unresectable Stage III Non-Small Cell Lung Cancer

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This multicenter retrospective study evaluated the efficacy and safety of sequential radiotherapy following induction immunochemotherapy or chemotherapy in patients with unresectable stage III non-small cell lung cancer (NSCLC) who showed insufficient response to induction treatment. The background highlights that while the PACIFIC trial demonstrated improved progression-free survival (PFS) with consolidative immune checkpoint inhibitor (ICI) therapy after concurrent chemoradiotherapy, a subgroup of patients progressed during induction therapy, warranting further analysis.<br /><br />Key eligibility included stage IIIA-C NSCLC patients over 18 years old with performance status 0-1 and inadequate response to induction therapy. Two groups were compared: one receiving induction immunochemotherapy followed by radiotherapy (IOC group, n=18), and the other receiving induction chemotherapy followed by radiotherapy (Chemo group, n=11). Endpoints assessed were PFS, overall survival (OS), objective response rate (ORR), disease control rate (DCR), and 12-month survival rate.<br /><br />Patient characteristics were balanced between groups with no significant differences in age, sex distribution, smoking status, histology, or stage. After a median follow-up of 20.6 months, the IOC group showed a statistically significant improvement in PFS compared to the chemotherapy-only group. However, no significant differences were observed in overall survival between groups.<br /><br />Safety profiles were comparable, with no statistically significant differences in adverse events such as radiation pneumonitis, hematologic toxicities, or organ function impairments. Grade III or higher radiation pneumonitis occurred in two patients, including one fatality in the IOC group related to pre-existing Pneumocystis jirovecii pneumonia.<br /><br />The study concludes that sequential radiotherapy following induction immunochemotherapy or chemotherapy is a feasible and effective option in unresectable stage III NSCLC patients with suboptimal induction responses, providing better progression-free survival and manageable toxicity. The findings also suggest potential benefits of immunotherapy re-challenge after radiotherapy.

Asset Subtitle

Yanhua Yang

Meta Tag

Speaker Yanhua Yang

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

unresectable stage III NSCLC

sequential radiotherapy

induction immunochemotherapy

induction chemotherapy

progression-free survival

overall survival

immune checkpoint inhibitor

radiation pneumonitis

PACIFIC trial

immunotherapy re-challenge