Is there a role for the addition of radiation to preoperative chemoimmunotherapy in NSCLC with limited N2 disease planned for surgery?

CheckMate 816 was a phase III randomized trial that demonstrated that adding nivolumab to platinum-based chemotherapy in the neoadjuvant setting improved pCR rates and event-free survival (Forde et al., PMID 35403841) and ultimately overall survival (NEJM 2025). The 5-year OS benefit was 10%, almost...

These are great answers. I do think a head-to-head comparison of the CheckMate 0816 vs PACIFIC would be good for patients and should be done. I personally don't think they will be any different in terms of OS, though I'd say that's somewhat of a hot take on my part. If you look at the two studies on...

I wouldn't do it. I also wouldn't endorse its study in a clinical trial, given the negative results of recent phase III studies evaluating concurrent chemo + immunotherapy + radiotherapy for locally advanced NSCLC (e.g., PACIFIC-2, CheckMate 73L, and KEYVIBE-006).