Adding precisely aimed, escalated doses of radiation after patients no longer respond to immunotherapy reinvigorates the immune system in some patients with metastatic non-small-cell lung cancer (NSCLC), increasing progression-free survival (PFS). Findings of the phase II randomized trial will be presented today at Adding precisely aimed, escalated doses of radiation after patients no longer respond to immunotherapy reinvigorates the immune system in some patients with metastatic non-small-cell lung cancer (NSCLC), increasing progression-free survival (PFS). Findings of the phase II randomized trial will be presented today at the 61st Annual Meeting of the American Society for Radiation Oncology (ASTRO) in Chicago.the 61st Annual Meeting of the American Society for Radiation Oncology (ASTRO) in Chicago.

“This study provides one more important piece of data that indicates that, for some patients, the immune system can be a really powerful tool to combat metastatic lung cancer,” said Allison M. Campbell, MD, PhD, a resident in the department of therapeutic radiology at Yale Cancer Center and lead author on the study. “It points us in the direction of places to look for biomarkers that might predict which patients would best respond to this type of therapy.”

NSCLC accounts for roughly 80-85% of all lung cancers. Approximately 57% of patients with NSCLC have already progressed to stage IV cancer at the time of diagnosis, meaning that tumors have spread to other parts of the body, making it difficult to cure. This type of cancer may be treated with radiation therapy, immunotherapy, surgery, chemotherapy or targeted drug therapy to relieve symptoms and allow patients to live longer.
This phase II prospective trial explored the benefits of treating one cancerous lesion with stereotactic body radiotherapy (SBRT) in patients with NSCLC whose cancer had continued to spread after treatment with pembrolizumab, a type of immunotherapy. Dr. Campbell and her team looked to see if tumors outside the treated area would also shrink, how long patients lived before their disease progressed after treatment and what was happening to the immune systems of those patients who responded well to the combination of SBRT and immunotherapy.

The study included 56 patients with NSCLC, all of whom had two or more measurable tumors at enrollment. Of these, six patients had already received immunotherapy and were immediately treated with SBRT, which delivers precise, intense doses of radiation. The other 50 patients had not yet been treated with immunotherapy; of these, 16 were treated with SBRT after their disease progressed after treatment with pembrolizumab (also known by its brand name Keytruda).

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