Radiation Oncology

SCRT plus ICIs leads neoadjuvant options for pMMR locally advanced rectal cancer

This network meta-analysis pooled seven RCTs (1132 pMMR LARC patients) comparing SCRT- and LCRT-based neoadjuvant strategies with or without ICIs. For curative-intent response (pCR or cCR with Watch-and-Wait), SCRT + ICIs ranked best among four strategies (SUCRA 98.5%). SCRT + ICIs significantly improved curative-intent response versus SCRT alone and LCRT alone, with a nonsignificant numerical advantage over LCRT + ICIs. Treatment rankings for pCR paralleled these findings, reinforcing SCRT as the preferred platform for ICI combination. 1

EGFR-mutant stage III NSCLC has worse PFS and more severe pneumonitis after cCRT

This pooled analysis of three randomized phase II trials included 274 unresectable stage III NSCLC patients treated with cCRT, 116 EGFR-mutant and 158 wild type. EGFR-mutant patients had significantly shorter PFS than wild type (HR 1.38; 95% CI 1.05–1.82), consistent across examined subgroups. Overall survival did not differ significantly between EGFR-mutant and wild-type groups (HR 0.98; 95% CI 0.70–1.38). Grade 3–4 pneumonitis occurred more often in EGFR-mutant patients than in wild type (7.8% vs 2.6%), warranting heightened surveillance. 2

GVAX, pembrolizumab, and SBRT show promising activity in locally advanced pancreatic cancer

This single-arm phase II trial enrolled 58 LAPC patients for GVAX vaccine, pembrolizumab, and SBRT after standard chemotherapy. Among 54 evaluable patients, 64.8% were considered potentially resectable after immunotherapy and SBRT, and 24 underwent R0/R1 resections. The overall resection rate was 44.4%, with 91.7% of resected patients achieving R0 margins. Median DMFS was 9.8 months overall and 20.3 months in resected patients, indicating substantial benefit from successful conversion to surgery. 3