Try trimodality.

What could be better than neoadjuvant chemoimmunotherapy for resectable non-small cell lung cancer (NSCLC)? Neoadjuvant radioimmunotherapy. A first of its kind phase 2 trial randomized 60 patients with resectable stage I-IIIA NSCLC receiving neoadjuvant durvalumab to +/- the addition of 8 Gy x 3 prior to surgery. Radiation was given on 3 consecutive days prior to the first cycle of durvalumab. Why the “sub-ablative” dose? A primary study goal was to observe a potential synergistic effect between radiation and immunotherapy. We’re still waiting on reporting of the efficacy, but here we learn that radiation didn’t add any detectable toxicity or surgical morbidity. Grade 3+ toxicity was identical in each arm, and there were no treatment related deaths. | Lee, J Thorac Cardiovasc Surg 2022