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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Wednesday, October 9, 2024
According to Florence Keane, MD, of Massachusetts General Hospital, Boston, and colleagues, the role of stereotactic body radiotherapy (SBRT) in the management of metastatic, oncogene-driven, non–small cell lung cancer (NSCLC) remains unknown, but focusing SBRT on the original involved site may reduce the risk of distant failures among patients on tyrosine kinase inhibitors (TKIs). The results of this trial, presented during the 2024 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 261), attributed no grade 3 or higher adverse events to the radiation therapy.
“Consolidation SBRT to predominantly the primary lung site in patients with oncogene-driven metastatic NSCLC was not associated with [a] decrease in frequency of distant failures, which constituted 50% of first failures at 1 year,” the study authors concluded. “Consideration should be given to consolidation SBRT to not only the primary site but also additional original sites of metastasis.”
A total of 27 patients with oncogene-driven, metastatic NSCLC who responded to or were stable on a TKI within 12 months of immunotherapy initiation were enrolled. Participants received SBRT at residual sites of original disease and remained on their TKI therapy. Of note, the trial was closed early due to slow accrual.
The median patient age was 59, and most participants were White (n = 20) and female (n = 17). EGFR driver mutations were identified in most patients (n = 22), followed by ALK mutations (n = 4) and ROS1 fusions (n = 1). All but two patients received consolidative SBRT to the residual lung primary tumor, and the median time from TKI initiation to SBRT was 6.4 months; the median dose was 44 Gy in five fractions. At the median follow-up of 50.4 months, the median progression-free survival was 14.7 months on SBRT, and the 2-year median local failure of irradiated sites was 12%. The median and 2-year overall survival rates were 70.8 and 88% months, respectively.
Disclosure: For Dr. Keane’s full disclosures, visit astro2024.eventscribe.net.
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