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Gregory J. Riely, MD, PhD


Chemoradiotherapy and Immune Checkpoint Inhibitors in NSCLC: Insights on Impact of Induction

By: Amanda E. Ruffino, BA
Posted: Thursday, February 1, 2024

Bi et al, of the Center for National Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, and colleagues investigated the optimal combination of immune checkpoint inhibitors and chemoradiotherapy for stage III non–small cell lung cancer (NSCLC). In a retrospective study of 123 patients in China, their findings were significant for 1- and 2-year progression-free survival rates of 75.3% and 56.9%, respectively, with a median progression-free survival of 30.8 months. More details on this study can be found in Frontiers of Immunology.

Upon subgroup analysis, patients receiving both induction and consolidation immune checkpoint inhibitors showed a significantly lower cumulative incidence of distant metastasis (hazard ratio = 0.30, 95% confidence interval = 0.09–1.00, P = .043) compared with those receiving consolidation immune checkpoint inhibitors alone. However, this group also exhibited a higher incidence of pneumonitis (P = .039). The study suggests a potential trade-off between reducing distant metastasis and an increased risk of pneumonitis when incorporating induction immune checkpoint inhibitors. Of note, in-field failure was the most common pattern, occurring in 18.7% of cases.

The combination of chemoradiotherapy and consolidation immune checkpoint inhibitors demonstrated notable efficacy and manageable toxicity for patients with stage III NSCLC in China, the researchers concluded. The study implies that adding induction immune checkpoint inhibitors may reduce distant metastasis, but this strategy seems to come with an elevated risk of pneumonitis.

Disclosure: The study authors reported no conflicts of interest.

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