Patients with extensive stage small cell lung cancer did not live longer with thoracic radiotherapy added to their chemo-immunotherapy in a study reported to the American Society of Clinical Oncology 2026 Annual Meeting held in Chicago, USA. First author Bjørn Henning Grønberg MD PhD, Professor and Consultant in Oncology at the Norwegian University of Science and Technology, St. Olavs Hospital in Trondheim, Norway talked with the Audio Journal of Oncology about his group’s findings.
Adding Thoracic Radiotherapy Did Not Prolong Lives of Patients with Extensive Stage Small Cell Lung Cancer Being Treated with Chemo-Immunotherapy
An interview with:
Bjørn Henning Grønberg MD PhD, Professor and Consultant in Oncology, Norwegian University of Science and Technology, St. Olavs Hospital, Trondheim, Norway.
Comment from:
David R Spigel MD, President & Chief Medical Officer, Sarah Cannon Research Institute, Nashville, Tennessee, USA
CHICAGO, USA—Patients with extensive stage small cell lung cancer did not live longer with thoracic radiotherapy added to their chemoimmunotherapy in a study reported to the American Society of Clinical Oncology 2026 Annual Meeting.
First author Bjørn Henning Grønberg MD PhD, Professor and Consultant in Oncology at the Norwegian University of Science and Technology, St. Olavs Hospital in Trondheim, Norway talked with the Audio Journal of Oncology’s Peter Goodwin about his group’s findings.
Peter then heard comments on the new data from David R Spigel MD, President and Chief Medical Officer at the Sarah Cannon Research Institute, Nashville, Tennessee, USA
AUDIO JOURNAL OF ONCOLOGY; Bjørn Henning Grønberg MD PhD
IN: [GOODWIN]”Peter Goodwin here, reporting from ASCO……
OUT: ……..of Oncology, I’m Peter Goodwin 9’43
ASCO 2026 ABSTRACT details: Abstract #: LBA8005:
Concurrent thoracic radiotherapy (TRT), platinum/etoposide chemotherapy, and durvalumab immunotherapy in extensive-stage (ES) small cell lung cancer (SCLC): A phase III trial.
Authors:
Bjørn H Grønberg, Daphne W. Dumoulin, Kersti Oselin, Luigi De Petris, Kirill Neumann, Tesfaye Madebo, Marianne Aanerud, Tarje O. Halvorsen, Johan Isaksson, Maria M. Bjaanæs, Daniel Heinrich, Odd Terje Brustugun, Atle Totland, Siv Gyda Aanes, Øyvind Yksnøy, Andreas Hallqvist, Orvar Gunnarsson, Terje Skraastad, Emelie Gezelius, Kristin T. Killingberg
Organizations:
Department of Oncology, St. Olavs hospital, Trondheim, Norway, Department of Pulmonary Medicine, Erasmus MC Cancer Institute, Rotterdam, Netherlands, Department of Chemotherapy, North Estonia Medical Centre, Tallinn, Estonia, Thoracic Oncology Center, Karolinska University Hospital, Stockholm, Sweden, Department of Pulmonology, Akershus University Hospital, Lørenskog, Norway, Department of Pulmonology, Stavanger University Hospital, Stavanger, Norway, Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway, Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology and Department of Oncology, St. Olavs Hospital, Trondheim, Norway, Center for Research and Development, Uppsala University/Region Gävleborg, Gavle, Sweden, Department of Oncology, Oslo University Hospital, Oslo, Norway, Department of Medical and Radiation Oncology and Centre for Palliative Care, Innlandet Hospital Trust, Gjøvik, Norway, Section of Oncology, Drammen Hospital, Vestre Viken HF, Drammen, Norway, Department of Pulmonology, Haugesund hospital, Haugesund, Norway, Department of Oncology and Palliative Medicine, Nordland Hospital Trust, Bodø, Norway, Department of Pulmonology, Ålesund Hospital, Ålesund, Norway, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg, Sweden, Department of Oncology, Landspitali, Reykjavík, Iceland, Department of Pulmonology, Hospital of Southern Norway, Kristiansand, Norway, Department of Respiratory Medicine, Skåne University Hospital, Lund, Sweden
Background:
A phase III trial indicated a survival benefit of TRT after chemotherapy in ES SCLC. A synergistic effect of concurrent radiotherapy and immunotherapy has been proposed and retrospective studies suggest that TRT improves survival in ES SCLC patients receiving chemoimmunotherapy (chemo-ICI). The main aim of this phase III trial was to investigate whether adding TRT to chemo- ICI improves overall survival (OS) in ES SCLC.
Methods:
Eligible patients were ≥18 years, had ECOG performance status (PS) 0-1 and disease stage III-IV (TNM 8) ineligible for curative chemoradiotherapy and were randomized 1:1 to chemo-ICI plus TRT («TRT») or chemo-ICI alone («C-I»), stratified by presence of liver and brain metastases. Patients received 4 courses of carboplatin (AUC 5), etoposide (100 mg/m2 iv day 1-3 or 100 mg/ m2 iv day 1 plus 200 mg/m2 po days 2-4) and durvalumab 1500 mg q3w, followed by durvalumab 1500 mg q4w until progression, unacceptable toxicity or patients wished to discontinue. TRT of 30 Gy/10 fractions to thoracic lesions started 21-28 days after day 1 of the 1st chemo-ICI cycle. Prophylactic cranial irradiation of 25-30 Gy/10-15 fractions was considered for those responding to chemo-ICI. Primary endpoint was OS, secondary endpoints include overall response rates (ORR), progression free survival (PFS) and toxicity. To show an increase in 1-year survival rates from 53% to 66% with a 2-tailed α of 0.05 and a β of 0.20, 128 patients were required in each group.
Results:
Enrolment started in January 2022 and was prematurely discontinued in September 2025 according to recommendations by the independent Data and Safety Monitoring Committee due to more serious adverse events (AE) in the TRT group and futility. By then, 228 patients from 20 European hospitals were randomized (TRT: n =115, C-I: n =113). Median age was 68 (range 39-84), 50.4% were female, 37.7% had PS 0, 96.1% stage IV disease, 39.9% metastases to the liver and 28.1% to the brain. Treatment groups were well balanced. Mean number of chemo-ICI courses was 3.6, mean number of total durvalumab courses 7.5 (range 1-30) and 91.3% in the TRT group received TRT. TRT did not improve OS (median 10.0 [TRT] vs. 11.1 months, HR 1.12, 95% CI 0.82-1.54, p=0.47), ORR (TRT: 88.5%, C-I: 89.6%, p=0.79) or PFS (median 5.1 [TRT] vs. 5.1 months, HR 1.09, 95% CI 0.83-1.44, p=0.53). Overall, there were more AEs in the TRT group (87.8% vs. 69.9%, p=0.006), but not more grade 3-4 AEs (TRT: 21.1%, C-I: 17.5%, p=0.33). Esophagitis occurred in 47.8% and grade 3-4 esophagitis in 10.4% of the TRT group. There were more deaths from other causes than SCLC in the TRT group (14.8% vs. 3.5%, p=0.003), though not significantly more when excluding deaths occurring before TRT commenced (9.6% vs. 3.5%, p=0.067).
Conclusion:
The addition of TRT after the first cycle of chemo-ICI did not improve treatment outcomes in ES SCLC.
Bjørn H. Grønberg MD PhD, ASCO 2026 A J Oncology, 2026, July 20
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