WCLC 2025 - Posters & ePosters-EP.09.06 Consolidative High-Dose Thoracic Radiotherapy in NSCLC Without Progression After First-Line Systemic Therapy With ICIs

Pdf Summary

This study investigates the role of high-dose consolidative thoracic radiotherapy (CTRT) in patients with advanced non-small cell lung cancer (NSCLC) who did not experience disease progression following first-line systemic therapy with immune checkpoint inhibitors (ICIs), with or without chemotherapy (CT). The primary focus was to evaluate acute lung toxicity within six months post-CTRT, while secondary endpoints assessed local failure-free survival (LFFS), progression-free survival (PFS), and overall survival (OS).<br /><br />Using a retrospective cohort of patients treated at the University Hospital of Parma and the University Hospital of Modena, the study found promising clinical outcomes associated with high-dose CTRT. Median progression-free survival was 20.2 months, and median overall survival reached 30.2 months. One-year and three-year local failure-free survival rates were 86.1% and 76.9%, respectively. Importantly, the rate of acute grade 2 radiation pneumonitis (RP) was within acceptable limits but showed correlation with the number of ICI cycles administered before radiotherapy.<br /><br />These findings highlight that for advanced NSCLC patients stable after first-line immunotherapy (± chemotherapy), consolidative thoracic radiotherapy can improve oncological outcomes with manageable acute pulmonary toxicities. Careful monitoring for pulmonary adverse events, especially pneumonitis, remains critical during and after treatment.<br /><br />Actionable Takeaways:<br />- High-dose CTRT post-ICI-based systemic therapy is effective and has an acceptable safety profile for non-progressive advanced NSCLC.<br />- Regular surveillance for early signs of lung toxicity is essential to manage possible adverse events promptly.<br />- The correlation of acute pneumonitis with ICI cycles suggests the need for individualized treatment planning.<br /><br />Future research should focus on prospective studies to confirm these results, optimize patient selection, and refine radiotherapy dosing schedules to maximize benefits while minimizing risks. This study advances the integration of immunotherapy and radiotherapy, offering improved survival prospects for NSCLC patients.

Asset Subtitle

Marco Galaverni

Meta Tag

Speaker Marco Galaverni

Topic Metastatic Non-small Cell Lung Cancer – Local Therapies

Keywords

high-dose consolidative thoracic radiotherapy

advanced non-small cell lung cancer

immune checkpoint inhibitors

chemotherapy

acute lung toxicity

local failure-free survival

progression-free survival

overall survival

radiation pneumonitis

immunotherapy and radiotherapy integration