ASTRO 2017: Tumor-Specific Modeling to Stratify Lung Cancer Patients for Therapy
A novel tumor-specific model may help clinicians to select patients with stage III non–small cell lung cancer (NSCLC) who would benefit most from concurrent chemotherapy combined with radiation (cCRT). With such stratification criteria for therapy sequencing, patients with little chance of benefit from cCRT may be spared the increased toxicity associated with this therapy.
Changran Geng, PhD, of Massachusetts General Hospital, Harvard Medical School, Boston, and colleagues presented their study findings at the 2017 Annual Meeting of the American Society for Radiation Oncology (ASTRO) in San Diego (Abstract 75). They generated a virtual patient population with a sample initial volume distribution and simulated the tumor growth, radiation effect, and chemotherapy based on the clinical data for patients with NSCLC.
Comparing cCRT and sequential chemoradiation (sCRT) in patient populations with variable tumor characteristics, the investigators found the model accurately predicted an overall survival benefit with cCRT in patients with stage III disease, which compared with the findings of the RTOG 9410 trial. For patients with faster tumor growth (above median), the benefit may be as high as 9.8%, compared with 2.1% for those with a slower tumor growth rate. In addition, there seemed to be a higher benefit for those with a larger tumor volume than for those with a smaller tumor volume.