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ASCO 2025 | The importance of radiation dose and quality in improving outcomes for patients with NSCLC
Shankar Siva, PhD, MBBS, FRANZCR, Peter MacCallum Cancer Centre, Melbourne, Australia, comments on the importance of radiation dose and quality in improving outcomes for patients with non-small cell lung cancer (NSCLC) treated with checkpoint blockade inhibitors. Dr Siva highlights that studies using high-quality radiation doses, including the Phase III SWOG/NRG S1914 (NCT04214262), have shown promising results, suggesting that even with checkpoint blockade therapy, better radiation quality can lead to improved outcomes. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
I think volume and dose probably matter. The important thing about both the SWOG study and the Achilles Norwegian study is they use very good doses of radiation. For the SWOG stereotactic radiotherapy study all of the schedules had above 100 gray biological equivalent dose, so these are good doses of radiation and it was high quality control as well during the radiotherapy delivery. For the Norwegian study they were using twice daily radiation which it’s sometimes a bit more complicated to do this with patient travel but certainly it has shown multiple trials to be a better option in small cell lung cancer patients than once daily radiotherapy for a longer period of time...
I think volume and dose probably matter. The important thing about both the SWOG study and the Achilles Norwegian study is they use very good doses of radiation. For the SWOG stereotactic radiotherapy study all of the schedules had above 100 gray biological equivalent dose, so these are good doses of radiation and it was high quality control as well during the radiotherapy delivery. For the Norwegian study they were using twice daily radiation which it’s sometimes a bit more complicated to do this with patient travel but certainly it has shown multiple trials to be a better option in small cell lung cancer patients than once daily radiotherapy for a longer period of time. So some of the signals that we’re seeing from this is that if you give good quality radiation perhaps the bar is set very high to improve this within terms of adding a drug therapy in terms of checkpoint blockade inhibition and also So even in those patients who are receiving these checkpoint blockade inhibitors, you can do better with better quality radiation as well.
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