Low-dose Radiation Therapy Concurrent With Atezolizumab and Chemotherapy as First-Line Treatment for Extensive-Stage Small Cell Lung Cancer: 3-Year Follow-up of a Multicenter, Single-arm, Phase 2 Trial (MATCH)

作者：Lin Zhou, Jianguo Sun, Conghua Xie, Kai Kang, Zhuoran Yao, Youling Gong, Meijuan Huang, Hui Wang, Lin Wu, Zhiyong Yuan, Nan Bi, Min Fan, Yaping Xu, Yao Chen, You Lu, You Lu · 发表于：International Journal of Radiation Oncology*Biology*Physics · 年份：2025 · DOI：10.1016/j.ijrobp.2025.06.3872 · 被引用次数：10 · 研究领域：Lung Cancer Research Studies、Lung Cancer Treatments and Mutations、Radiopharmaceutical Chemistry and Applications

PURPOSE: Preclinical studies showed that low-dose radiation therapy (LDRT) may act synergistically with immunotherapy in small cell lung cancer (SCLC); however, its role in the treatment of extensive-stage SCLC (ES-SCLC) remains unclear. METHODS AND MATERIALS: ), and atezolizumab (1200 mg), with concurrent LDRT (15 Gy in 5 fractions [3 Gy/fraction]), followed by atezolizumab maintenance therapy until loss of clinical benefit, unacceptable toxicity, withdrawal of consent, or death. The primary endpoint was the confirmed objective response rate. The secondary endpoints were progression-free survival (PFS) and overall survival (OS). RESULTS: Fifty-six eligible patients were enrolled between December 16, 2020, and March 30, 2022. The median follow-up was 36.1 months (IQR, 30.9-38.7) at the cutoff date (June 30, 2024). The confirmed objective response rate was 87.5% (95% CI, 75.9-94.8). The median PFS and OS were 6.9 months (95% CI, 5.4-9.3) and 16.9 months (95% CI, 14.0-32.9), respectively. The PFS rates at 1 and 3 years were 27.3% and 20.7%, respectively, and the OS rates at 1 and 3 years were 69.6% and 35.1%. The median depth of tumor response among patients with confirmed objective response was 70.2%. The 3-year OS rates were 57.4% and 18.8% in patients above and below the median depth of tumor response, respectively (hazard ratio, 0.28; 95% CI, 0.13-0.60). The most common treatment-related grades 3 to 5 adverse events were decreased neutrophil count (60.7%) and decreased whit...