WCLC 2022 | Impact of radiation dose to immune cells in unresectable or stage III NSCLC in the durvalumab era

Neal Sean McCall, MD, Winship Cancer Institute, Emory University, Atlanta, GA, discusses the Impact of radiation dose to immune cells in unresectable or stage III non-small cell lung cancer (NSCLC) in the durvalumab era. The Phase III Oncology RTOG 0617 (NCT00533949) trial investigating high-dose or standard-dose radiation therapy and chemotherapy with or without cetuximab in treating patients with newly diagnosed stage III unresectable NSCLC had negative results and found, paradoxically, that patients who were dose-escalated fared worse in terms of overall-survival (OS) and disease control than those with standard-dose 60 Gy in a secondary analysis. The new standard of care (SOC) for unresectable stage III NSCLC is consolidative durvalumab, given to patients for a year following concurrent chemoradiation. The estimated dose to the immune cells (EDIC) in patients following treatment on durvalumab showed that patients with higher EDIC had shorter OS, PFS, worse local regional disease control and shorter time to brain metastasis. Thus, reducing the amount of radiotherapy received by immune cells is critical to improve patient prognosis. This interview took place at the IASLC 2022 World Conference on Lung Cancer congress in Vienna, Austria.