2529 - Efficacy and Safety of Hypofractionated Radiotherapy Plus Sequential Chemotherapy with Immunotherapy in Patients with Locally Advanced, Unresectable, Stage III Non-Small Cell Lung Cancer
Presenter(s)
Y. Yu1, J. Yu2, D. Yang2, Y. Liu3, X. Chang2, L. Jiang2, D. Xin2, R. Yu4, H. Yu2, and A. SHI2; 1Department of Oncology, Beidahuang Group General Hospital, Harbin, Heilongjiang, China, 2Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China, 3Department of Oncology,Beidahuang Group General Hospital, Harbin, China, 4Department of Radiation Oncology, Peking University Cancer Hospital & Institute,Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, China
Purpose/Objective(s): Hypofractionated radiotherapy (HypoRT) is a promising treatment with high locoregional control for unresectable stage III non-small cell lung cancer (NSCLC). Since the Pacific-6 and GEMSTONE-301 trial, sequential chemoradiotherapy followed by consolidation immune checkpoint inhibitors (cICI) has become the standard of care.We aimed to assess the efficacy and safety of hypofractionated radiotherapy as the treatment for NSCLC.
Materials/Methods: A total of 101 real-world patients with unresectable stage III non-small cell lung cancer (NSCLC)treated between March 2018 and January 2023 were divided into sequential chemoradiotherapy alone (HypoCRT arm) or sequential chemoradiotherapy plus cICI (iHypoCRT arm). iHypoCRT arm: 52 patients received chemotherapy followed by sequential hypofractionated radiotherapy with doses ranging from 60 to 66 Gy, delivered in 15 fractions, patients who does not have disease progression after HypoRT received cICI. HypoCRT arm: 49 patients received chemotherapy followed by sequential HypoRT, without cICI The primary endpoint of the study was overall survival(OS).Secondary endpoints included progression-free survival (PFS)local progression-free survival (LPFS) and treatment-related adverse events.
Results: At a median follow-up of 17.5 months. The median overall survival (OS) was 33 months in the iHypoCRT group versus 22 months in the HypoCRT group(p=0.018). The median progression-free survival (PFS) was 17 months in the iHypoCRT group compared to 10 months in the HypoCRT group(p=0.027).Grade 3 or 4 treatment-related adverse events occurred in four (8%) of 52 patients in the iHypoCRT group versus two (4%) of 49 patients in the HypoCRT group.
Conclusion: This study demonstrated that HypoRT combined with sequential chemotherapy in patients with locally advanced, unresectable, stage III NSCLC, combined with cICI as consolidation therapy yielded a promising sclinical outcomes and well tolerated.