For a study, researchers sought to understand that immunotherapy has significantly altered how non-small cell lung cancer (NSCLC) in advanced stages is treated. However, immunotherapy often negatively impacts people who do not express Programmed Death-Ligand 1 (PD-L1). The study intended to test the concept that systemic therapy, such as immunotherapy combined with stereotactic body radiation therapy (SBRT) to a single tumor location, may significantly improve outcomes in patients with advanced stage PD-L1(-) NSCLC. Based on subgroup analysis from the randomized phase II PEMBRO-RT research, Alliance A082002 revealed that adding SBRT to pembrolizumab improved progression-free and overall survival in PD-L1(-) patients (8 Gy x 3 fractions). Therefore, to patients in A082002 who did not express PD-L1, SBRT (8 Gy x 3) in combination with systemic therapy or systemic therapy alone will be randomly assigned. PFS will serve as the project’s major outcome indicator throughout phase II, including 100 participants. For phase III of the trial, which will have 284 more participants, OS will be used as the main end indicator. This project examined how long PFS and OS can last when SBRT and systemic therapy are used together. There were several systemic treatment modalities, such as immunotherapy by itself or chemo-immunotherapy. In patients with stage IV PD-L1(-) NSCLC, the phase II/III Alliance trial A082002 aimed to determine if the addition of SBRT to a single tumor site can improve the anti-tumor efficacy of systemic immunotherapy or chemo-immunotherapy. Currently, the National Clinical Trials Network (NCTN) provides access.

 

Source: sciencedirect.com/science/article/abs/pii/S1525730422000651