Immunotherapy was often less effective in patients who did not exhibit the protein Programmed Death-Ligand 1 (PD-L1). Combined with systemic therapy, including immunotherapy, this trial saw if stereotactic body radiation therapy (SBRT) to a single tumor location will significantly improve the outcome of patients with advanced-stage PD-L1(-) NSCLC. PEMBRO-RT examined pembrolizumab alone or with SBRT and found that adding SBRT enhanced progression-free and overall survival (PFS and OS, respectively) in PD-L1(-) patients. Alliance A082002 was based on subgroup analysis from the randomized phase II PEMBRO-RT study (8 Gy x 3 fractions). Patients who did not have PD-L1 expression will be randomized to SBRT (8 Gy x 3) + systemic therapy vs. systemic therapy alone in A082002. The trial’s primary goal in phase II was PFS, which would require 100 patients. The trial’s primary goal in phase III was OS, which required an additional 284 individuals. This research determined whether adding SBRT to systemic therapy improved PFS and OS in a broader multi-institutional cohort. Immunotherapy alone or chemo-immunotherapy were 2 of the systemic therapeutic approaches available. In patients with stage IV PD-L1(-) NSCLC, the phase II/III Alliance trial A082002 saw if adding SBRT to a single tumor site improves the anti-tumor effectiveness of systemic immunotherapy or chemo-immunotherapy. The National Clinical Trials Network (NCTN) was accepting applications.

Source: www.clinical-lung-cancer.com/article/S1525-7304(22)00065-1/fulltext

Author