How do you sequence thoracic consolidation RT and PCI with incorporation of immunotherapy in ES-SCLC?

In the IMpower133 study, "during the maintenance phase, prophylactic cranial irradiation was permitted as per local standard-of-care, but thoracic radiation with curative intent or the intent to eliminate residual disease was not permitted. Palliative thoracic radiation was allowed. (quoting from th...

IMPOWER 133 did not allow thoracic consolidation. It did allow PCI (about 11% pts got PCI on each study arm). Since Takahashi, et al (Lancet Oncol 2017;18(5):663-671), our radiation oncologists favor MRI brain monitoring rather than PCI for extensive-stage SCLC patients, given lack of survival benef...

I recently was thinking about this very question. As a gedankenexperiment, and nothing more, I superimposed IMPower133 curves on top of Slotman's thoracic RT for ES-SCLC trial. As far as I know, the control arms in both trials got similar treatments (platinum/etoposide, PE, chemo only). What's provo...

Talking points to consider as we are considering how radiation should be used following the results of the IMpower study

As Dr Werner-Wasik pointed out, PCI was allowed on the study while Thoracic radiation was not. The problem is only 10% of pts on the study received PCI presumably related to concer...