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ASTRO 2021: Targeted Radiation Therapy for Oligoprogressive Metastatic Lung Cancers

By: Lauren Harrison, MS
Posted: Friday, November 5, 2021

Stereotactic body radiotherapy (SBRT) appears to be beneficial in the treatment of oligoprogressive metastatic non–small cell lung cancer (NSCLC), leading to an improvement in survival. However, the interim analysis found that stereotactic radiation did not extend progression-free survival in patients with advanced breast cancer. C. Jillian Tsai, MD, PhD, of the Memorial Sloan Kettering Cancer Center in New York, presented these interim analysis results at the 2021 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract LBA-3).

“Our results show that lung cancer patients with oliogoprogressive tumors can obtain a meaningful benefit using this approach,” said Dr. Tsai in an institutional press release.

This trial enrolled patients with either NSCLC or breast cancer who had received at least one line of systemic therapy but developed oligoprogressive lesions. Patients were randomly assigned 1:1 to receive either SBRT to all progressive sites plus palliative standard of care or palliative standard of care alone.

Among the 58 patients with lung cancer enrolled in the trial, 30 received SBRT and 28 were in the control group. An additional 44 patients with breast cancer were included. After a median follow-up of 51 weeks, 71 of the patients in the full cohort had experienced disease progression, and 30 had died.

The median progression-free survival among the entire cohort was 22 weeks for patients receiving SBRT and 10 weeks in the palliative-care arm (P = .005). This benefit was driven entirely by the lung cancer cohort, as the progression-free survival was 44 weeks with SBRT and 9 weeks without it (P = .004). After multivariate analysis to control for age, sex, lines of systemic therapy, and change of systemic therapy, the survival benefit seen with SBRT remained substantial (hazard ratio = 0.38, P = .007), the investigators reported. Grade 2 or higher adverse events occurred in eight patients receiving SBRT, including one with grade 3 pneumonitis.

Disclosure: For Dr. Tsai’s disclosures, visit plan.core-apps.com.



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