Abstract 712P
Background
With the advent of immunotherapy, immunotherapy combined with chemotherapy has become the first-line standard treatment for stage IV non-small cell lung cancer (NSCLC). However, approximately 70 percent of patients developed disease progression after first-line standard therapy, of which approximately 50 percent had local progression of the lung primary lesion. Therefore, we conducted a retrospective study to explore the efficacy and safety of first-line immunotherapy combined with chemotherapy followed by consolidated thoracic radiotherapy (TRT) in patients with stage IV NSCLC.
Methods
A retrospective analysis was performed on 66 patients with stage IV NSCLC who received immunotherapy combined with chemotherapy at the first line of the Affiliated Hospital of Binzhou Medical College from March 2020 to February 2023. These patients who received immunotherapy had stable disease for at least 3 months. During this period, follow-up consolidated thoracic radiotherapy (TRT group) or non-consolidated thoracic radiotherapy (non-TRT group) was performed aiming at the primary lung cancer. The primary outcome measures were progression-free survival (PFS), and the secondary outcome measures were overall survival (OS), optimal objective response rate (ORR), and treatment-related toxicity.
Results
A total of 66 patients were included; 33 patients received immune checkpoint inhibitors plus chemotherapy and radiotherapy (TRT group), and 33 patients received immunochemotherapy alone (non-TRT group). Compared with non-RT group, the PFS in RT group was significantly longer (15.0 months vs.10.0 months, p=0.0086), and the OS in RT group showed an extended trend (36.0 months vs. 31.0 months, p=0.279), and ORR was higher (66.7% vs. 57.6%, p=0.0098). One patient in both RT group or non-RT developed grade 4 immune-related-pneumonia, and none of the remaining patients developed grade ≥ 3 immune-related-pneumonia.
Conclusions
For patients with stage IV NSCLC, first-line immunotherapy combined with chemotherapy followed by consolidated thoracic radiotherapy showed a survival benefit without a significant increase in treatment-related pulmonary toxicity.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.