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Latest Research in Lung Cancer

Across the world, radiation oncologists are actively researching safe and effective radiation treatments, including more personalized approaches and studies of lower doses for a variety of cancers. The following research studies were presented during the ASTRO Annual Meeting in October 2020. Annually, ASTRO hosts the largest gathering of radiation oncology professionals in the world to share the latest science and research, all designed to improve patient care, support clinical practice and advance science and research in the field of radiation oncology. 

The information provided below highlights the research provided in the studies included in the Best of ASTRO onDemand course. This information is not intended as medical advice. It is important to review and discuss all treatment options, including radiation therapy with your primary care physician before determining which option or combination of options is best for you and your lifestyle. 

Studies in Lung Cancer

Discussant: Rachel Blitzblau, MD, PhD
Patient Takeaways prepared by Rachel Blitzblau, MD, PhD, and Jolinta Lin, MD

Hess et al: Immunomodulatory low dose whole-lung RT for COVID-19-related pneumonia:

  • Low dose whole lung RT appears to reduce lung inflammation from Covid-19
  • Reduced inflammatory markers
  • Reduced radiographic ARDS picture
  • May reduce intubation rate
  • May reduce time to clinical recovery
  • Comparison to drug interventions not available
  • May be complementary to drug intervention
  • Long-term risks unknown

Higgins et al: Patterns of disease progression on IMPower 133:

  • Atezolizumab improves the time to developing brain metastases compared to chemotherapy alone in patients with ES-SCLC.
  • Prophylactic cranial irradiation can reduce the development of new brain lesions by about 10% in patients with ES-SCLC.
  • Further studies on PCI vs observation, the role of hippocampal-sparing PCI in preserving neurocognitive function, and SRS for brain metastases from ES-SCLC are under way.

Siva et al: TROG 13.01 SAFRON II single fraction vs 4 fraction SABR:

  • Stereotactic body radiation therapy (SABR) may be delivered as a single dose or few doses.
  • SABR is a great, noninvasive treatment modality that results in high efficacy and local control with generally a low risk of side effects.
  • Understanding of side effects in combination with novel drugs is still evolving.

Louie et al: A phase III randomized trial of palliative radiation for advanced central lung tumors with intentional avoidance of the esophagus (PROACTIVE):

  • Cardiac/coronary artery sparing needs to be optimized in radiation treatment planning:
    • Reduce major adverse cardiac events (MACE).
    • Consider optimizing cardiac care with a cardiologist.
  • Effective esophageal sparing is possible with advanced radiation techniques:
    • Reduce patient-reported esophageal symptoms.
    • Improve quality of life.
    • Decrease objective esophagitis rates.

Kong et al: RTOG0617 to externally validate blood cell ERCC1/2 genotypic signature as a radiosensitivity biomarker for both tumor and normal tissue for individualized dose prescription:

  • Metformin plays no role in improving progression-free survival in stage III NSCLC treated with concurrent chemo-RT.
  • Genotypic signatures of tumor and normal tissues will likely inform future individualized radiation treatment regimen.

Download the PDF of the Best of ASTRO Patient Takeaways
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