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ASCO 2026 | Phase III trial of radiotherapy added to chemo-immunotherapy in ES-SCLC
Bjorn Henning Gronberg, MD, PhD, Norwegian University of Science and Technology, Trondheim, Norway, presents results from a Phase III trial (NCT05223647) evaluating the addition of concurrent thoracic radiotherapy to carboplatin, etoposide, and durvalumab in patients with extensive-stage small cell lung cancer (ES-SCLC). The trial was terminated early due to futility and increased adverse events; results demonstrated no improvement in overall survival, progression-free survival, or objective response rate with the addition of thoracic radiotherapy, alongside higher rates of serious adverse events in that arm. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
The main finding was that there was no survival benefit of adding thoracic radiotherapy to chemoimmunotherapy in extensive-stage small cell lung cancer. In addition, there were more adverse events, and most importantly, there were more treatment-related deaths in the experimental group. We have done some exploratory subgroup analysis, and we haven’t been able to identify any subgroups that appear to benefit from the addition of thoracic radiotherapy...
The main finding was that there was no survival benefit of adding thoracic radiotherapy to chemoimmunotherapy in extensive-stage small cell lung cancer. In addition, there were more adverse events, and most importantly, there were more treatment-related deaths in the experimental group. We have done some exploratory subgroup analysis, and we haven’t been able to identify any subgroups that appear to benefit from the addition of thoracic radiotherapy. Since most other trials administer the radiotherapy after the chemoimmunotherapy we also looked at patients who completed all four planned chemoimmunotherapy courses and also there were no signs of effect. And the best prognosis group, the patients without brain or liver metastases, also there was no signal of an effect. So I think this trial tells us that adding thoracic radiotherapy should not be done outside of clinical trials, with, of course, the exception of patients who have symptoms from tumor compression of the central structures. They should probably receive palliative radiotherapy as before.
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