Jun 5, 2019

Lung Cancer for Radiation Oncologists — Part 1: Our interview with Dr Rimner highlights the following topics and cases from his practice:

• Evaluation, staging and typical disease management approaches for patients with locally advanced non-small cell lung cancer (NSCLC) (00:00)
• Selection and dose of postoperative radiation therapy (RT) (3:34)
• Stereotactic body RT (SBRT) versus surgery for patients with early-stage NSCLC (8:57)
• Case: A man in his mid-70s, a former smoker, with Stage IIIC adenocarcinoma of the lung receives durvalumab consolidation after chemoradiation therapy (CRT) (11:52)
• Optimal design of the radiation treatment field; mitigation of RT-associated side effects (14:05)
• Results of the Phase III RTOG-0617 trial evaluating carboplatin/paclitaxel in combination with standard- versus high-dose conformal RT, with or without cetuximab, for Stage III NSCLC (18:19)
• Role of RT in enhancing tumor immunogenicity (22:47)
• Avoiding safety concerns with the combination of CRT and immune checkpoint inhibitors (26:41)
• Activity and tolerability of pembrolizumab after RT in patients with NSCLC on the Phase I KEYNOTE-001 trial (29:09)
• PACIFIC trial: Efficacy and tolerability of durvalumab after CRT for patients with unresectable Stage III NSCLC (31:00)
• Activity of durvalumab after CRT; diagnosis and management of pneumonitis associated with durvalumab/CRT (36:14)
• Ongoing Phase II trial evaluating the activity and safety of nintedanib with prednisone for the treatment of radiation pneumonitis (39:51)
• Incidence of pneumonitis with CRT alone and with the addition of durvalumab (43:19)
• Survival outcomes and duration of consolidation therapy with durvalumab (44:33)
• Ongoing evaluation of immune checkpoint inhibitors with concurrent RT with or without chemotherapy (47:53)
• Activity of immune checkpoint inhibitors in the neoadjuvant setting (50:04)
• Selection of the optimal dose and technique of RT for locally advanced NSCLC (51:57)
• Case: A woman in her early 70s with unresectable Stage IIIB adenocarcinoma of the lung and a KRAS mutation receives CRT followed by durvalumab (56:12)
• Clinical experience with the use of durvalumab after CRT (58:44)
• Case: A woman in her mid-50s with Stage III adenocarcinoma of the lung and an EGFR mutation receives adjuvant osimertinib (1:1:44)
• Increased RT precision with the merging of MRI and a linear accelerator (1:5:46)

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