Study Predicts Important Role for SABR in Treatment of Early-stage NSCLC

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SABR may be used to improve PFS, or potentially OS, among patients who have a good response to chemotherapy, targeted therapy, or immunotherapy.
SABR may be used to improve PFS, or potentially OS, among patients who have a good response to chemotherapy, targeted therapy, or immunotherapy.

Long-term study results indicate that stereotactic ablative radiotherapy (SABR) for inoperable, early-stage non–small cell lung cancer (NSCLC) provided overall survival (OS), locoregional, and distant disease control rates comparable to those seen with surgery, all with low toxicity.1

In the phase 2 clinical trial, 65 patients with stage I NSCLC were treated with 50 Gy SABR given over 4 fractions. With a median follow-up of 7.2 years, disease recurrence occurred in about one-fourth of patients (27.7%); 5-year progression-free (PFS) and overall survival (OS) were 49.5% and 55.7%, respectively.

“That means that 50% of people still survived without disease 5 years later,” study author Joe Y. Chang, MD, PhD, professor of radiation oncology and director of stereotactic ablative radiotherapy at the MD Anderson Cancer Center in Houston, Texas, told Cancer Therapy Advisor. “Considering that the mean age was 71 years old, 5 years later the age is 76 — that is the average life expectancy for people in the US.”

The median time to any recurrence was 14.5 months. The incidence of local, regional, and distant disease recurrence at 5 years was 8.1%, 10.9%, and 11.0% respectively; at 7 years, these risks were 8.1%, 13.6%, and 13.8%, respectively.

“These data confirm previously published data with a median follow-up of about 3 years, but now with 7 years of follow up,” Dr Chang said.

The most commonly occurring toxicities were dermatitis (32.3%), radiation pneumonitis (87.7%), and chest wall pain (45.4%). These were mostly grade 1 or 2.

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