Articles related to RADIOTHERAPY

A phase II study of durvalumab alone or combined with the anti-CD73 monoclonal antibody oleclumab or anti-NKG2A monoclonal antibody monalizumab as consolidation therapy in patients with unresectable stage III NSCLC and no progression after concurrent chemoradiotherapy. With a median follow-up of 11.5 months, both combinations increased ORR and prolonged PFS versus durvalumab alone. Safety was similar across arms with no new or significant safety signals identified with either combination.

Short-term radiotherapy with preoperative chemotherapy followed by surgery (total neoadjuvant therapy, TNT) was compared to standard long-term chemoradiotherapy in patients with locally advanced rectal cancer. At a median follow-up of 35.0 months, 3-year DFS was 64.5% and 62.3% in the TNT and CRT groups, respectively. There was no significant difference in metastasis-free survival or locoregional recurrence, but the TNT group had better 3-year overall survival than the CRT group (86.5% v 75.1%; P = .033). Treatment effects on DFS and overall survival were similar regardless of prognostic factors. The prevalence of acute grade III-V toxicities during preoperative treatment was 26.5% in the TNT group versus 12.6% in the CRT group (P < .001).

Chemoradiotherapy with high-dose cisplatin every three weeks is the standard adjuvant treatment for patients with locally advanced squamous cell carcinoma of the head and neck with high risk for recurrence. However, the cisplatin dose is frequently reduced because of dose-related toxicities which can result in insufficient cisplatin delivery. Chemoradiotherapy with weekly cisplatin at a dose of 40 mg/m2 is widely used as a possible alternative, albeit without sufficient evidence. This clinical trial was conducted to prove the noninferiority of weekly cisplatin to three weekly cisplatin plus radiation therapy (RT).

This update on the PACIFIC trial comparing durvalumab with placebo in patients with unresectable, stage III non–small-cell lung cancer demonstrated robust and sustained OS and durable PFS benefit. The updated, exploratory analyses of survival, approximately 5 years after the last patient was randomly assigned demonstrate robust and sustained OS and durable PFS benefit with durvalumab after chemoradiotherapy. An estimated 42.9% of patients randomly assigned to durvalumab remain alive at 5 years and 33.1% of patients randomly assigned to durvalumab remain alive and free of disease progression. These results establish a new benchmark for standard of care in this setting.

Initial results of the PREOPANC trial — comparing the addition of neoadjuvant chemoradiation therapy of gemcitabine combined plus Gy radiotherapy to standard care — failed to demonstrate a statistically significant overall survival (OS) improvement versus standard care of upfront surgery followed by adjuvant therapy. The long-term results, however, demonstrate significant benefit with neoadjuvant chemoradiation therapy consisted of gemcitabine combined plus Gy radiotherapy. The five year OS rate was 20.5% (95% CI, 14.2 to 29.8) with neoadjuvant chemoradiotherapy and 6.5% with upfront surgery.

The authors of this JCO study used a PET-adaptive approach to reduce the need for radiotherapy (RT) in early PET (-) disease and escalate therapy in patients with PET (+) disease. The study reports excellent outcomes for the approach, which allowed omission of radiotherapy in more than three-quarters of patients.