WCLC 2025 - Posters & ePosters-P1.11.07 Impact of Radiotherapy and Immune Checkpoint Inhibitor Combination in Advanced NSCLC: Real-World Data (RWD) Analysis

P1.11.07 Impact of Radiotherapy and Immune Checkpoint Inhibitor Combination in Advanced NSCLC: Real-World Data (RWD) Analysis

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This multicenter retrospective study analyzed real-world data from 2,179 patients with stage IV non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) in Spain. The focus was to assess how the intent and timing of radiotherapy (RT) combined with ICIs influence survival outcomes. Among these patients, 21.8% received RT, predominantly with palliative intent (88%) and less frequently with radical intent (12%). Common irradiation sites included bone, central nervous system, and lung.<br /><br />Key findings demonstrated that radical RT combined with ICIs was associated with significantly improved overall survival (OS) and progression-free survival (PFS) compared to either ICIs alone or ICIs with palliative RT. Median OS was 27.3 months for radical RT plus ICIs versus 19.4 months for ICIs alone and 17.3 months for palliative RT plus ICIs. Similarly, median PFS was longest in the radical RT group (8.7 months) compared to 6.0 months for ICIs alone and 4.6 months for palliative RT with ICIs. Patients receiving palliative RT exhibited worse prognosis.<br /><br />Regarding treatment sequencing, patients were categorized into groups based on RT and ICI timing: ICI before RT (ICI/RTseq), concurrent ICI and RT (ICI/RTco), RT before ICI (RT/ICIseq), and mixed sequences. Concurrent ICI/RT showed the most favorable survival outcomes (median OS 20.3 months), whereas sequential approaches (ICI then RT or RT then ICI) were linked to worse OS and PFS compared to ICIs alone.<br /><br />In conclusion, the study supports that in advanced NSCLC, combining radical radiotherapy with ICIs and administering them concurrently leads to better survival outcomes. Palliative RT and sequential treatment sequencing correlate with poorer prognosis. These results highlight the importance of optimizing radiotherapy strategy and timing when integrated with immunotherapy to improve patient outcomes.

Asset Subtitle

Joaquim Bosch Barrera

Meta Tag

Speaker Joaquim Bosch Barrera

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

stage IV non-small cell lung cancer

immune checkpoint inhibitors

radiotherapy

radical radiotherapy

palliative radiotherapy

overall survival

progression-free survival

treatment sequencing

concurrent therapy

real-world data