When standard chemotherapy stops working for advanced lung cancer, doctors and patients are searching for the next best option. A new study tested whether adding a precise, high-dose radiation treatment—called stereotactic ablative body radiation therapy (SABR)—to the immunotherapy drug nivolumab could help. The idea was to use radiation to 'wake up' the immune system against the cancer.
The trial involved 50 adults whose metastatic non-small cell lung cancer had progressed after one or two lines of chemotherapy. They were randomly assigned to receive either nivolumab alone or nivolumab plus a single dose of SABR targeted at one tumor site. After a median follow-up of 26 months, the key finding was that the combination did not significantly improve the main goal of keeping the cancer from progressing at six months. Rates of tumor shrinkage and overall survival were also similar between the two groups.
Importantly, the rates of serious side effects were high and comparable in both groups, affecting about three-quarters of patients. A major caveat is that the study had to stop enrolling patients early, so it ended up with far fewer participants than planned. This means the trial was underpowered—it may have missed detecting a real, but small, benefit or difference. The results show the two approaches had similar effectiveness and safety in this limited test, but a larger study would be needed for a clearer conclusion.
