Multimodality treatment in synchronous oligometastatic NSCLC: Analysis of the ETOP CHESS trial

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2025-04-21 DOI:10.1016/j.lungcan.2025.108553

Matthias Guckenberger , Isabelle Opitz , Tereza Dellaporta , Alessandra Curioni-Fontecedro , Thomas Frauenfelder , Karin Ribi , Ferdinando Cerciello , Ivana Sullivan , Lizza Hendriks , Miriam Dorta , Ana Callejo , Joachim Aerts , Alfredo Addeo , Anne-Marie C. Dingemans , Giulia Pasello , Mariano Provencio , Filippo de Marinis , Nuria Mederos-Alfonso , Heidi Roschitzki-Voser , Barbara Ruepp , Rolf Stahel

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引用次数: 0

Abstract

Objective

To evaluate the addition of immunotherapy and metastasis-directed stereotactic body radiotherapy (SBRT) to induction chemotherapy followed by definitive local therapy of the locoregional primary tumour in patients with synchronous oligometastatic non-small cell lung cancer (NSCLC).

Methods

CHESS is a prospective, international, multicentre, single-arm, phase II trial evaluating the efficacy and safety of combined chemotherapy (carboplatin plus paclitaxel), immune checkpoint inhibition (durvalumab) and metastasis-directed SBRT, followed by definitive radiotherapy or surgery of the primary tumour (if no disease progression at the 3-month restaging) and maintenance durvalumab for maximum one year in patients with synchronous oligometastatic NSCLC. The primary endpoint was one-year progression-free survival, aiming to an improvement from 25% to 50%.

Results

A total of 49 patients were enrolled from 11/2019 to 07/2022. Up to 05/2023, the median follow-up was 22 months. Of 47 patients starting treatment, 10 progressed and 2 died before restaging, while 35 proceeded to definitive therapy of the locoregional primary (11 surgery, 24 radiotherapy). Among the first 42 evaluable patients, 14 (33%; ≥17 required) reached one year without progression, and the null hypothesis could not be rejected. The one-year overall survival rate for all patients was 74.9% (95% CI: 60.0%–84.9%). Treatment-related grade ≥ 3 adverse events were reported in 34% of patients, with no grade 5 event.

Conclusion

The CHESS trial did not meet its primary endpoint. However, the favourable safety profile and promising overall survival provided the basis for further intensification of induction systemic therapy (addition of tremelimumab in a subsequent study cohort; CHESS–Cohort 2).

查看原文本刊更多论文

同步少转移性NSCLC的多模式治疗：ETOP CHESS试验分析

目的探讨同步性少转移性非小细胞肺癌（NSCLC）患者在诱导化疗的基础上加用免疫治疗和转移定向立体定向放射治疗（SBRT）后局部原发性肿瘤的最终治疗效果。方法：schess是一项前瞻性、国际、多中心、单组、II期试验，评估联合化疗（卡铂+紫杉醇）、免疫检查点抑制（durvalumab）和转移导向SBRT的疗效和安全性，随后对原发肿瘤进行明确放疗或手术（如果在3个月的再分期中没有疾病进展），并在同步少转移性NSCLC患者中维持durvalumab最多一年。主要终点是一年无进展生存期，目标是从25%提高到50%。结果2019年11月至2022年7月共入组49例患者。截至5/2023，中位随访时间为22个月。在47例开始治疗的患者中，10例进展，2例在重新治疗前死亡，而35例进行了局部原发的最终治疗（11例手术，24例放疗）。在首批42例可评估患者中，14例(33%；≥17例)达到1年无进展，不能拒绝原假设。所有患者的一年总生存率为74.9% （95% CI: 60.0%-84.9%）。34%的患者报告了治疗相关的≥3级不良事件，没有5级不良事件。结论CHESS试验未达到其主要终点。然而，良好的安全性和有希望的总生存期为进一步加强诱导全身治疗提供了基础(在随后的研究队列中添加tremelimumab；CHESS-Cohort 2)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.