Dr Bjorn Henning Gronberg speaks to ecancer about concurrent thoracic radiotherapy (TRT), platinum/etoposide chemotherapy, and durvalumab immunotherapy in extensive-stage (ES) small cell lung cancer (SCLC).

ES-SCLC remains a highly aggressive disease with poor outcomes. While prior studies suggested a survival benefit from TRT after chemotherapy, and a potential synergy between radiotherapy and immunotherapy, this phase III trial evaluated whether adding TRT to chemoimmunotherapy (carboplatin, etoposide, and durvalumab) could improve outcomes.

Dr Gronberg says that in this randomised study, patients received chemoimmunotherapy with or without TRT. The addition of TRT did not improve overall survival, progression-free survival, or response rates compared with chemoimmunotherapy alone. Median overall survival was similar between groups, and no efficacy advantage was observed.

Importantly, the TRT arm experienced significantly higher rates of adverse events, including esophagitis and more deaths from non-cancer causes. Due to increased toxicity and lack of benefit, the trial was stopped early for futility.

These findings indicate that adding TRT after initial chemoimmunotherapy does not improve clinical outcomes in ES-SCLC and may increase treatment-related risks.