What question did this study set out to answer?

To evaluate the efficacy and safety of consolidative thoracic radiotherapy (CTRT) after immune checkpoint inhibitors (ICIs) in advanced NSCLC patients.

March 21, 2026Open Access

92P IMMUNOLung80: Outcomes of first-line immunotherapy in octogenarians with advanced NSCLC - A multicentre study

Key Points

To evaluate the efficacy and safety of consolidative thoracic radiotherapy (CTRT) after immune checkpoint inhibitors (ICIs) in advanced NSCLC patients.
Conducted retrospective single-institution analysis
Included NSCLC patients treated with CTRT after first-line (CT-)ICIs
Assessed local failure-free survival (LFFS), progression-free survival (PFS), overall survival (OS)
Graded toxicities using Common Terminology Criteria for Adverse Events (CTCAE)
1-year LFFS was 87.1% and 3-year LFFS was 66.4%
Median PFS was 19.6 months and median OS was 48.8 months
Grade 2 radiation pneumonitis incidence was 27.9%; Grade 3 and Grade 5 were 11.6% and 2.3% respectively
Acute Grade 2 RP was significantly associated with the duration of prior ICI therapy.

Abstract

Background: Consolidative thoracic radiotherapy (CTRT) improves outcomes in advanced non-small cell lung cancer (NSCLC) after chemotherapy (CT).However, the efficacy and safety of high-dose CTRT following immune checkpoint inhibitors (ICIs) are not fully characterized.This study evaluates CTRT outcomes and toxicity in NSCLC patients previously treated with (CT-)ICIs.Methods: A retrospective single-institution analysis was conducted on patients receiving CTRT after first-line (CT-)ICIs.Primary endpoints were local failure-free survival (LFFS), progression-free survival (PFS), and overall survival (OS) using the Kaplan-Meier method.Toxicities were graded via Common Terminology Criteria for Adverse Events (CTCAE).Results: 43 patients with NSCLC treated between 2019 and 2024 were included.At presentation, 48.8% had locally advanced disease unsuitable for definitive chemoradiotherapy, while 51.2% were metastatic.Most (88.4%) received PD-1 inhibitors (median 6 cycles, range 1-31).CTRT median equivalent dose in 2 Gy fractions was 50.0 Gy, with 51.2% receiving radical doses (median 59.2 Gy) and 48.8% subradical doses (median 48.8 Gy).At a median follow-up of 35.7 months (95% CI: 28.9-45.3):-Survival: 1-year and 3-year LFFS were 87.1% and 66.4%.Median PFS was 19.6 months (95% CI: 9.8-NE); median OS was 48.8 months (95% CI: 15.5-NE).-Toxicity: Grade 2 radiation pneumonitis (RP) incidence was 27.9% (occurring at a median of 2.3 months post-CTRT).Grade 3 and Grade 5 RP occurred in 11.6% and 2.3%, respectively.-Correlations: Acute Grade 2 RP was significantly associated with prior ICI duration (9.5% for 6 cycles vs. 40.0%for 7 cycles; p= .03).Prescribed CTRT dose did not significantly impact RP rates (27.3% radical vs 28.6% subradical, p= .92).-Overall Pulmonary Events: Grade 2, grade 3 and grade 5 pulmonary event rates (all etiologies) were 32.6%, 18.6% and 7.0%, respectively. Conclusions:For advanced NSCLC responding to first-line ICIs, high-dose CTRT provides encouraging oncological control with manageable toxicity.Notably, prolonged ICI administration prior to CTRT significantly increases the risk of acute RP.

KI fragen

Bookmark

View Full Paper