Local consolidative therapy fails to improve survival in metastatic NSCLC
The phase III LONESTAR trial tested local consolidative therapy (radiation or surgery) after 12 weeks of induction with nivolumab plus ipilimumab in patients with stage IV EGFR/ALK wild‑type non‑small cell lung cancer. Among 166 patients, median overall survival was 43.2 months with LCT plus dual immunotherapy versus 52.8 months with dual immunotherapy alone (HR 1.14, P=0.54), and there was no statistically significant PFS benefit. The study closed for futility; subgroup analyses showed a negative OS trend in oligometastatic patients and an OS benefit only in those under 65, while mediastinal radiation was linked to increased lymphopenia and pneumonitis rates were numerically higher.
LCT after nivolumab‑ipilimumab did not improve survival in trial
Context
Patients with stage IV NSCLC received 12 weeks of nivolumab and ipilimumab. Those without progression were randomized to continue immunotherapy alone or add local consolidative therapy. The trial was stopped for futility and further…
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