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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...

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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

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Radiotherapy(R) Integration(I) Strategy for Small(S)-Cell Lung Cancer in Extensive(E) Stage (RISE) with up to 10

Łukasz Kuncman^1,2, Jacek Fijuth^1,2, Damian Tworek³

¹Department of Radiotherapy, Medical University of Łódź, Łódź, Poland.

|January 25, 2025

Summary

This study investigates radiotherapy strategies for extensive-disease small-cell lung cancer (ED-SCLC) patients receiving chemo-immunotherapy. Findings suggest dose-escalated chest radiotherapy and SBRT may improve overall survival and progression-free survival for ED-SCLC.

Keywords:

Chemotherapy Immunotherapy Lung cancer Oligometastatic disease Radiotherapy

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Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

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Area of Science:

Oncology
Radiation Oncology
Medical Oncology

Background:

The standard of care for extensive-disease small-cell lung cancer (ED-SCLC) is chemo-immunotherapy.
Radiotherapy (RT) is effective for chest consolidation in chemotherapy-responsive ED-SCLC patients.
Data on RT for chest consolidation and metastasis-directed therapy in ED-SCLC is limited.

Purpose of the Study:

To evaluate the effectiveness of different RT strategies for residual lesions in ED-SCLC patients undergoing chemo-immunotherapy.
The RISE study aims to assess RT's role in improving outcomes for ED-SCLC.

Main Methods:

165 ED-SCLC patients with stable or partially regressed disease on chemo-immunotherapy will be randomized into three arms.
Arm I: Standard of care (SoC) with PD-1/PD-L1 immunotherapy. Arm II: SoC with consolidative chest RT (30 Gy) and palliative RT to metastases.
Arm III: SoC with escalated chest RT (45 Gy) and stereotactic body radiotherapy (SBRT) to metastases (24 Gy). Circulating tumor DNA (ctDNA) will be analyzed.

Main Results:

Primary endpoint is progression-free survival (PFS) or death.
Secondary endpoints include overall survival (OS), treatment toxicity, response rates (ORR), and progression patterns.

Conclusions:

ED-SCLC patients have a poor prognosis.
Dose-escalated chest RT and SBRT for metastases show potential to improve OS and PFS in ED-SCLC.
Modern RT techniques may enhance treatment efficacy for ED-SCLC.