How do the results of the phase 2 TREASURE trial for consolidative RT for ES-SCLC impact your practice?

Thoracic radiotherapy is defined not only by dose, but critically by treatment volume. The TREASURE protocol permitted large CTV expansions, discretionary irradiation of clinically uninvolved nodal regions, and substantial additional PTV margins. Elective nodal irradiation is not part of contemporar...

The randomized phase 2 TREASURE trial was a European trial that asked whether adding consolidative thoracic radiotherapy (TRT) given as 30 Gy in 10 fractions to maintenance atezolizumab improves outcomes in extensive-stage small cell lung cancer (ES-SCLC). The rationale for this trial was to answer ...

This trial informs that using IO’s concurrently with a responding group of 68 patients may be associated with adverse events, including death.

The use of 30 Gy to an unspecified thoracic target produced lymphopenia, as occurs with all thoracic targets in SCLC; it is not dose-related, occurs early, a...

I agree with the sentiment offered by the prior comments.

I want to add that the radiation fraction size is an important factor in determining the risks of thoracic RT. So, these patients were treated to (potentially) "largish" volumes (as noted by Dr. @Dr. First Last), and were treated at 3 Gy/frac...