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Poster session 15

1051P - Radiotherapy (RT) and efficacy of immune checkpoint inhibitors (ICI), chemotherapy (CTx) and chemoimmunotherapy (CIT) in patients with non-small cell lung cancer (NSCLC)


10 Sep 2022


Poster session 15


Clinical Research;  Cytotoxic Therapy;  Immunotherapy;  Radiation Oncology

Tumour Site

Non-Small Cell Lung Cancer


Alexander Meisel


Annals of Oncology (2022) 33 (suppl_7): S448-S554. 10.1016/annonc/annonc1064


A. Meisel1, M.T. Mark2, A. Haider3, L. Holer4, S. Hayoz4, C. Gebhard1, S. Bengs1, V. Treyer1, S.I. Rothschild5, M.J. Hochmair6, D.R. Gandara7, F. Cappuzzo8, M. Reck9, F. Stenner-Liewen10, R.A.F. von Moos2

Author affiliations

  • 1 Department Of Nuclear Medicine, USZ - University Hospital Zürich, 8091 - Zurich/CH
  • 2 Department Of Medical Oncology & Hematology, KSGR - Kantonsspital Graubünden, 7000 - Chur/CH
  • 3 Department Of Radiology, Harvard Medical School, Massachusetts General Hospital, 02114 - Boston/US
  • 4 Statistics, Swiss Group for Clinical Cancer Research (SAKK), 3008 - Bern/CH
  • 5 Department Of Medical Oncology And Comprehensive Cancer Center, University Hospital Basel, 4031 - Basel/CH
  • 6 Respiratory Oncology Unit, Department Of Respiratory And Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, 1210 - Vienna/AT
  • 7 Internal Medicine & Hematology-oncology Dept., University of California Davis Comprehensive Cancer Center, 95817 - Sacramento/US
  • 8 Medical Oncology, IRCCS Istiuto Nazionale Tumori Regina Elena (IRE), 00144 - Rome/IT
  • 9 Oncology, LungenClinic Grosshandorf, 22927 - Grosshansdorf/DE
  • 10 Department Of Oncology, University Hospital Basel, 4031 - Basel/CH


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Abstract 1051P


Preclinical and retrospective clinical studies have suggested that local RT enhances the activity of ICI mediated by the so called abscopal effect – a systemic response in metastatic cancer induced by local irradiation. The most recent prospective trials have not been able to support this hypothesis.


In this study we have included a total of 3’079 NSCLC patients with squamous and non-squamous histology from three phase-III trials that investigated the efficacy of atezolizumab in combination with different first-line chemotherapies or as second-line monotherapy. Contrary to earlier studies we have analyzed prior and on-study RT. To investigate the differences between various RT schedules (on-study), we divided the patients in three subgroups based on single-dose fraction: A ≤ 2 Gray (Gy), B > 2 Gy ≤ 5 Gy, C > 5 Gy. Overall survival (OS) and progression-free survival (PFS) were investigated using Kaplan-Meier estimates and Cox proportional hazard models. Nominal p-values were determined by log-rank tests. Overall response rate (ORR) estimates were calculated using the Clopper-Pearson method.


Prior and on-study RT were not associated with prolonged OS (Table). We have also been unable to observe improvements in PFS and ORRs. In contrast, OS tended to be numerically worse [Intention-to-treat (ITT) populations of IMpower130: 14.0 vs 18.6 months, hazard ratio (HR) 1.23, p = 0.048; IMpower150: 15.0 vs 19.1 months, HR 1.18, p = 0.087; OAK 10.3 vs 12.0 months, HR 1.18, p = 0.023] with a comparable magnitude across the three trials. Patients receiving on-study RT (n = 213) showed an improved OS with single dose fractions > 5 Gy (19.2 vs 13.4 months, HR 0.60, p = 0.006). Table. Table: 1051P

IMpower130 (n = 705) IMpower150 (n = 1’187) OAK (n = 1’187)
Prior RT + - OS 16.5 vs 19.2 HR 1.18, p = 0.211 OS 12.0 vs 17.7 HR 1.38, p = 0.073 OS 16.4 vs 20.5 HR 1.26, p = 0.179 OS 19.1 vs 20.4 HR 1.14, p = 0.438 OS 12.3 vs 16.4 HR 1.24, p = 0.167 OS 12.1 vs 14.1 HR 1.28, p = 0.023 OS 9.0 vs 10.9 HR 1.15, p = 0.186
On-study RT + OS 18.1 vs 18.6 HR 0.99, p = 0.964 OS 13.5 vs 15.9 HR 1.09, p = 0.692 OS 11.1 vs 19.7 HR 1.33, p = 0.220 OS 13.4 vs 20.4 HR 1.77, p = 0.083 OS 14.0 vs. 15.2 HR 1.20, p = 0.583 OS 15.1 vs 13.1 HR 0.95, p = 0.798 OS 6.2 vs 10.3 HR 2.43, p = 0.003

OS in months A Atezolizumab, B Bevacizumab, C Carboplatin, P Paclitaxel, NP Nab-P, D Docetaxel # HR and p-values are stratified


We could not find any evidence for an abscopal effect leading to improved outcomes irrespective of the systemic treatment. Since RT increases toxicity, our results do not support the use of RT unless there is a clinical indication.

Clinical trial identification

IMpower130: NCT02367781; IMpower150: NCT02366143; OAK: NCT02008227.

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Kantonsspital Graubünden.


A. Meisel: Financial Interests, Personal, Advisory Board: Amgen, Astellas, Boehringer Ingelheim, BMS, Celgene, GSK, Janssen, Merck, MSD, Novartis, Roche, Sanofi, Servier, Takeda, Vifor; Financial Interests, Personal, Advisory Role: Gerresheimer; Financial Interests, Institutional, Funding: Merck & Cie; Financial Interests, Personal, Invited Speaker: Bayer; Financial Interests, Personal, Funding: Bayer; Financial Interests, Personal, Expert Testimony: Sanofi; Financial Interests, Personal, Other: Amgen, Boehringer Ingelheim, Janssen, Merck, Roche, Sanofi, Servier; Financial Interests, Personal, Writing Engagements: Astellas. M.T. Mark: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, Roche, MSD, Takeda; Financial Interests, Institutional, Funding: AstraZeneca. S.I. Rothschild: Financial Interests, Personal, Advisory Role: AstraZeneca, Boehringer Ingelheim, BMS, Eisai, Roche, Novartis, Merck Serono, MSD, Pfizer, Takeda, AbbVie; Financial Interests, Funding: Boehringer Ingelheim, AstraZeneca, BMS, Eisai, Merck Serono, AbbVie; Financial Interests, Personal, Expert Testimony: Roche, AstraZeneca, BMS. M.J. Hochmair: Financial Interests, Personal, Speaker’s Bureau: AstraZeneca, BMS, Boehringer Ingelheim, MSD, Roche, Takeda; Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, Boehringer Ingelheim, MSD, Roche, Takeda. D.R. Gandara: Financial Interests, Funding: Amgen, AstraZeneca, Genentech, Merck, BMS; Financial Interests, Institutional, Advisory Board: AstraZeneca, Roche-Genentech, Guardant Health, IO Biotech, Oncocyte, BMS; Financial Interests, Personal, Other, Personal Fees: Inivata, Eli Lilly, Merck, Novartis. F. Cappuzzo: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Roche, Takeda, Pfizer, Bayer. M. Reck: Financial Interests, Personal, Other, honoraria for lectures and consultancy: Amgen, AstraZeneca, BMS, Boehringer Ingelheim, MSD, Roche, Eli Lilly, Merck, Mirati, Novartis, Pfizer, Samsung Bioepis. F. Stenner-Liewen: Financial Interests, Personal, Advisory Board: AstraZeneca, Bayer, BMS, Janssen, MSD, Sanofi; Financial Interests, Personal, Other, Travel/Accommodation: BMS, Roche, Sanofi. R.A.F. von Moos: Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, BMS, GSK, Gilead, MSD, Roche, Pfizer, PharmaMar; Financial Interests, Personal, Writing Engagements: Vifor; Financial Interests, Personal, Speaker’s Bureau: Vifor; Financial Interests, Personal, Other, Educational events/lectures/presentations: Vifor. All other authors have declared no conflicts of interest.

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