Is there a role for adjuvant chemotherapy and/or immunotherapy for early stage, N0 non-small cell lung cancer treated with SBRT alone?

Excellent question. There is certainly a need! If we step back and take an honest look at our control rates with SBRT, while primary tumor control rates are high, we suffer the same viciousness of lung cancer that surgeons do - local control is trumped by a 2-3x rate of regional and distant failure....

Only in the setting of a clinical trial. In the standard of care setting, there is no role for adjuvant therapy here.

There is not currently a proven role for systemic therapy in this population, although several randomized trials (such as SWOG/NRG S1914) are currently evaluating this question. Based on the surgical literature, one might expect a benefit to chemotherapy for the sub-group of patients with tumors lar...

Agree with the answers above and with some nuance. Completion of the phase III trials will be decisive in IO benefit in early-stage non-small cell lung cancer (ES-NSCLC). However, it's likely that NGS and IHC will start to pivot in how we individually approach ES-NSCLC treatment after SABR (and surg...

SBRT + Atezo trial will be opening soon.

Based on our updated I-SABR result with improved OS and persistent activation of immune cytotoxic T cells with the addition of Nivo to SABR, there is for sure a role for immunotherapy in early-stage N0M0 NSCLC treated with SBRT. However, this I-SABR study alone has not been sufficient to change prac...

There is certainly a role for adjuvant "something" after curative-intent SBRT for early-stage, N0 non-small cell lung cancer (NSCLC). Earlier in my career, we anticipated this need. We had evaluated patterns of failure for early-stage NSCLC patients treated with SBRT alone and had noted, like many o...