The standard of care for treating cancer has seen marked changes in recent years. However, despite advances in immunotherapy and radiation therapy, non-small cell lung cancers (NSCLC), which make up 80%-85% of all lung cancers, have poor patient outcomes.
Ryan Whitaker, MD, PhD, assistant professor of Radiation Oncology at Vanderbilt University Medical Center, and colleagues tested a new adaptive treatment combining immunotherapy and radiation therapy to treat these cancers. The treatment regimen, online adaptive radiotherapy, is tailored to real-time tumor changes during the treatment plan. As reported in the journal Cureus, the researchers treated a 67-year-old male newly diagnosed with Stage 4 oligometastatic NSCLC, where cancer metastasized to multiple sites, including the adrenal glands.
The patient underwent five treatment sessions split over a 12-week course. The radiation treatment plan was adjusted dynamically in response to the normal anatomy and tumor changes, which were monitored using cone beam computed tomography. The course resulted in a significant reduction in tumor volume (by about 85% and 83% in left and right adrenal tumors, respectively). The patient reported no acute toxicity and saw improvements in cough and abdominal pain.
The findings suggest that the tailored online adaptive radiotherapy approach may be effective for managing newly diagnosed metastatic NSCLC while minimizing exposure to healthy tissues. While further data is needed, the case presents a potential clinical benefit to improve the quality of life in patients with metastatic lung cancer.
The patient was treated as part of the prospective clinical trial SiCARIO (Split-Course Adaptive Radioimmunotherapy for Oligometastatic NSCLC, NCT05501665).
Others participating in the study were first author Kyra McComas, MD, Sarah Masick, CRNP, Adam Yock, PhD, and Evan Osmundson, MD, PhD. The research was supported by Varian.
