Do you hold immunotherapy when administering lung SBRT?
One example of this scenario would be a patient receiving consolidative durvalumab after chemoRT for stage III NSCLC who develops a new peripheral lung nodule requiring SBRT. Are there any data to guide what pneumonitis risk to quote?
Answer from: Radiation Oncologist at Academic Institution
Good question, limited data to inform an answer.An ongoing trial ("iSABR") in which we are participating involves giving durvalumab 5 days prior to lung SBRT for early stage NSCLC and then continuing that agent for a total of 5 cycles; data are maturing, so I can't offer an estimate of pneumonitis r...
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Answer from: Radiation Oncologist at Academic Institution
@Brian D. Kavanagh wrote a very thorough answer and I agree with his conclusion that generally 'concurrent' ICI with thoracic SBRT is safe based on limited retrospective and prospective experiences. Our ongoing iSABR study has completed the Phase I safety portion. All 15 patients in the Phase ...
Answer from: Radiation Oncologist at Academic Institution
I do not routinely hold immunotherapy with lung SBRT. There is a substantial body of literature that suggests thoracic radiation is safe in tandem with immunotherapy, including several prospective trials (Welsh et al., PMID 32916308, etc). Furthermore, several ongoing trials are currently testing im...