Immunotherapy concurrently administered with chemoradiotherapy in limited-stage small-cell lung cancer

Few advancements in treating limited-stage small-cell lung cancer (LS-SCLC) have been made in decades. We aim to explore the efficacy and safety of immune checkpoint inhibitors (ICIs) in combination with concurrent chemoradiotherapy (cCRT) for treating LS-SCLC.

This study recruited patients with LS-SCLC. cCRT consisted of etoposide and a platin with once daily (60 Gy/30 fractions) or twice daily radiotherapy (45 Gy/30 fractions). ICIs was started concurrently with cCRT and continued for up to 2 years. The primary endpoint was progression-free survival (PFS) and safety.

A total of 29 patients were enrolled. All patients underwent at least one cycle of ICI during cCRT. With the median follow-up duration of 28.4 months, the median PFS was 13.1 months (95% CI: 10.7-15.6), and the 2-year PFS rate was 40%. The median OS was not reached with a 2-year OS rate of 69.8%. The objective response was achieved in 72.4% of patients. There were no grade 5 toxicities, but there was one grade 3 allergic reaction. Pneumonitis with a grade 3 rate was 10.3%. All 21 esophagitis events (72.4%) were grade 1 to 2. There were several grade 4 (10.3%) events (neutropenia) which were well managed.

ICIs concurrent with cCRT for LS-SCLC exhibited promising clinical efficacy. The relatively high incidence of grade 3 pneumonitis suggests that the selection of cCRT combined with ICI requires careful consideration in clinical practice for some patients.