What is the role of consolidative thoracic radiotherapy in the era of chemo-immunotherapy for extensive stage small cell lung cancer?

摘要

Recent advances in the systemic treatment for extensive stage small cell lung cancer (ES-SCLC) have led to chemoimmunotherapy as part of the new standard of care. Both the IMpower 133 (1) and CASPIAN (2) trials demonstrated an improvement in overall survival (OS) with the addition of immunotherapy to first-line chemotherapy. Notably these trials did not allow definitive consolidative thoracic radiation, given limited data regarding safety of thoracic radiation and immunotherapy. As a result, there is currently uncertainty around if and how to integrate consolidative thoracic radiation into the chemo-immunotherapy backbone for ES-SCLC. This editorial commentary will address these timely and important issues.