James Urbanic, MD, associate professor, Radiation Medicine and Applied Sciences, University of California, San Diego, discusses the evolution of radiation therapy in the treatment of patients with oligometastatic non—small cell lung cancer (NSCLC).

Historically, chemotherapy has had modest effectiveness in this population. This led surgeons to pioneer the idea of taking out a few small metastatic sites, Urbanic says. Similarly, as radiation progressed, Urbanic says that radiologists have gotten better at picking off small sites of disease with very high-dose radiation treatments. This has provided the opportunity to control those spots in 9 out of 10 cases.

As chemotherapy improved, the idea of interdigitating radiation therapy into the overall treatment plan of a patient with oligometastatic NSCLC is beginning to make more sense, says Urbanic. Patients with smaller amounts of metastatic disease have experienced longer durable survival times, Urbanic concludes.

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James Urbanic, MD, associate professor, Radiation Medicine and Applied Sciences, University of California, San Diego, discusses the evolution of radiation therapy in the treatment of patients with oligometastatic non–small cell lung cancer.
 

Dr. Urbanic on the Evolution of Radiation in NSCLC

James Urbanic, MD, associate professor, Radiation Medicine and Applied Sciences, University of California, San Diego, discusses the role of radiotherapy in oligometastatic non—small cell lung cancer (NSCLC).

Now that physicians have immunotherapy, Urbanic says that they are figuring out where exactly to interdigitate radiation treatment. Urbanic says it may be upfront in trying to generate a heightened immune response, or it may have a role further into the treatment course as a means to re-stimulate efficacy after immunotherapy. It may also be used after shrinking larger tumors to a certain size.

Data from a recent study published in the 

 looking at chemotherapy versus chemotherapy plus immunotherapy suggested a benefit that exceeds anything that has ever been seen in metastatic lung cancer, Urbanic says. This will impact how physicians think about interdigitating radiation. If anything, it is going to make it more important as more patients with a historically poor prognosis are introduced to the treatment, says Urbanic.

James Urbanic, MD, associate professor, Radiation Medicine and Applied Sciences, University of California, San Diego, discusses the role of radiotherapy in oligometastatic non–small cell lung cancer (NSCLC).

James Urbanic, MD

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Dr. Urbanic on the Evolution of Radiation in NSCLC

Dr. Urbanic on the Role of Radiotherapy in Oligometastatic NSCLC