TY - JOUR
T1 - A Review of Concurrent Chemo/Radiation, Immunotherapy, Radiation Planning, and Biomarkers for Locally Advanced Non-small Cell Lung Cancer and Their Role in the Development of ECOG-ACRIN EA5181
AU - Varlotto, John Michael
AU - Sun, Zhuoxin
AU - Ky, Bonnie
AU - Upshaw, Jenica
AU - Fitzgerald, Thomas J.
AU - Diehn, Max
AU - Lovly, Christine
AU - Belani, Chandra
AU - Oettel, Kurt
AU - Masters, Gregory
AU - Harkenrider, Matthew
AU - Ross, Helen
AU - Ramalingam, Suresh
AU - Pennell, Nathan A.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/11
Y1 - 2022/11
N2 - ECOG-ACRIN EA5181 is a current prospective, randomized trial that is investigating whether the addition of concomitant durvalumab to standard chemo/radiation followed by 1 year of consolidative durvalumab results in an overall survival benefit over standard chemo/radiation alone followed by 1 year of consolidative durvalumab in patients with locally advanced, unresectable non-small cell lung cancer (NSCLC). Because multiple phase I/II trials have shown the relative safety of adding immunotherapy to chemo/radiation and due to the known synergism between chemotherapy and immunotherapy, it is hoped that concomitant durvalumab can reduce the relatively high incidence of local failure (38%-46%) as seen in recent prospective, randomized trials of standard chemo/radiation in this patient population. We will review the history of radiation for LA-NSCLC and discuss the role of induction, concurrent and consolidative chemotherapy as well as the concerns for late cardiac and pulmonary toxicities associated with treatment. Furthermore, we will review the potential role of next generation sequencing, PD-L1, ctDNA and tumor mutation burden and their possible impact on this trial.
AB - ECOG-ACRIN EA5181 is a current prospective, randomized trial that is investigating whether the addition of concomitant durvalumab to standard chemo/radiation followed by 1 year of consolidative durvalumab results in an overall survival benefit over standard chemo/radiation alone followed by 1 year of consolidative durvalumab in patients with locally advanced, unresectable non-small cell lung cancer (NSCLC). Because multiple phase I/II trials have shown the relative safety of adding immunotherapy to chemo/radiation and due to the known synergism between chemotherapy and immunotherapy, it is hoped that concomitant durvalumab can reduce the relatively high incidence of local failure (38%-46%) as seen in recent prospective, randomized trials of standard chemo/radiation in this patient population. We will review the history of radiation for LA-NSCLC and discuss the role of induction, concurrent and consolidative chemotherapy as well as the concerns for late cardiac and pulmonary toxicities associated with treatment. Furthermore, we will review the potential role of next generation sequencing, PD-L1, ctDNA and tumor mutation burden and their possible impact on this trial.
UR - http://www.scopus.com/inward/record.url?scp=85134751386&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85134751386&partnerID=8YFLogxK
U2 - 10.1016/j.cllc.2022.06.005
DO - 10.1016/j.cllc.2022.06.005
M3 - Review article
C2 - 35882620
AN - SCOPUS:85134751386
SN - 1525-7304
VL - 23
SP - 547
EP - 560
JO - Clinical Lung Cancer
JF - Clinical Lung Cancer
IS - 7
ER -