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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

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Intensity-Modulated Radiotherapy for Locally Advanced Lung Cancer in the Immunotherapy Era: A Prospective Study

Hideyuki Harada¹, Akito Hata², Masahiro Konno¹

¹Radiation and Proton Therapy Center, Shizuoka Cancer Center, Nagaizumi, Japan.

JTO Clinical and Research Reports

|May 8, 2025

Summary

Intensity-modulated radiotherapy-adapted chemoradiotherapy followed by durvalumab showed a high introduction rate and promising efficacy in unresectable locally advanced NSCLC patients. The treatment demonstrated a favorable safety profile with low severe pneumonitis incidence.

Keywords:

Chemoradiotherapy Durvalumab Immunotherapy Intensity-modulated radiation therapy Non–small cell lung cancer

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Area of Science:

Oncology
Radiation Oncology
Medical Oncology

Background:

Chemoradiotherapy (CRT) followed by durvalumab is standard for unresectable locally advanced NSCLC.
Limited prospective data exist for intensity-modulated radiotherapy (IMRT)-adapted CRT in the immunotherapy era.

Purpose of the Study:

To evaluate the durvalumab introduction rate after IMRT-adapted CRT.
To assess the efficacy and safety of this treatment regimen.

Main Methods:

A multicenter prospective observational study enrolled 32 patients with unresectable locally advanced NSCLC.
Patients received IMRT-adapted CRT (60 Gy IMRT with platinum-doublet chemotherapy) followed by durvalumab.
The primary outcome was the durvalumab introduction rate within 42 days post-CRT.

Main Results:

Durvalumab was introduced in 85.7% of 28 evaluable patients, meeting the primary endpoint.
Median progression-free survival was 20.9 months; median overall survival was not reached.
No treatment-related deaths or grade 4 nonhematological adverse events were reported. Grade 1-3 pneumonitis occurred in 72% of patients.

Conclusions:

IMRT-adapted CRT followed by durvalumab achieves a high durvalumab introduction rate.
The regimen shows suggested efficacy and a favorable safety profile, with low severe pneumonitis incidence.