Radical local treatment for patients with NSCLC following oligoprogression after chemoradiation and durvalumab
In brief
Local treatment was followed by 19-month median survival in selected lung cancer patients
In this retrospective study, 41 of 198 patients with locally advanced lung cancer and limited progression after chemoradiation and durvalumab received treatment to all progressing sites. Median survival after local treatment was 18.7 months, but there was no comparison group to show whether treatment improved outcomes; longer durvalumab benefit and no brain metastases were linked to better survival, and prospective studies are needed.
- Journal
- European journal of cancer (Oxford, England : 1990) (Q1)
- Published
- 29 October 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Federico Pravisano, Francesco Cortiula, Amin H Nassar, Martina Bortolot, Andrea Riccardo Filippi, Lorenzo De Marchi, et al.
- PMID
- 42967453
- DOI
- 10.1016/j.ejca.2026.117811
Why clinicians should know about it
- Picked for Radiation Oncology (paper of the day, 6 November 2026): Radiotherapy-inclusive local ablation for oligoprogression after chemoradiation
Abstract
BACKGROUND: The role of local ablative therapy (LAT) in patients with locally advanced NSCLC who develop oligoprogressive disease (oligo-PD) after chemoradiotherapy (CRT) and maintenance durvalumab remains unclear. MATERIALS AND METHODS: This multicenter retrospective study included patients with locally advanced NSCLC who developed oligo-PD after CRT and at least one dose of durvalumab and received exclusive LAT at seven centers (2016-2023). Oligo-PD was defined as ≤ 5 progressive sites across ≤ 3 organs. LAT comprised surgery, radical-dose radiotherapy, or cryoablation with curative intent to all progression sites. PFS and OS were measured from LAT using the Kaplan-Meier method. Cox models assessed prognostic factors. RESULTS: Among 198 patients with progression during or after durvalumab, 41 received exclusive LAT for oligo-PD. LAT consisted of radiotherapy, surgery ± radiotherapy, and cryoablation in 71%, 27%, and 2%, respectively. Median PFS was 11.0 months (95% CI 7.9-36.7) and median OS was 18.7 months (95% CI 11.1-NR). One- and two-year PFS rates were 47.2% and 32.6%; corresponding OS rates were 61.7% and 46.1%. In multivariable analyses, PFS ≥ 12 months from durvalumab initiation (OS: HR 0.33, 95% CI 0.12-0.86; p = 0.023; PFS: HR 0.39, 95% CI 0.17-0.87; p = 0.022) and absence of brain metastases (OS: HR 0.30, 95% CI 0.11-0.87; p = 0.026; PFS: HR 0.43, 95% CI 0.19-0.99; p = 0.049) were associated with better outcomes. CONCLUSIONS: In selected patients with oligo-PD after CRT and durvalumab, exclusive LAT may be feasible and associated with encouraging survival. Prospective studies are needed to validate these findings.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.