Immunotherapy with Radiation for SCLC

[Jjwb]

My wife was diagnosed with E-SCLC in December 2022 - about 4 cm lung tumor and some spine lesions. She started a clinical trial of carboplatin/etoposide/ atezolizumab (Tecentriq) in January, with the potential to get atezolizumab/lurbinectedin in the maintenance phase of the trial. The first part of the trial went quite well, with the primary tumor shrinking about 50% after the first two sessions, but then did not shrink further.

She was randomized to atezolizumab only (no lurbinectedin) for the maintenance phase, so we are pretty sure we are going to exit the trial and start radiation together with atezolizumab (after consulting with a radiation oncologist).

We would greatly appreciate any advice or experience on this course of action, and thank you for all the great content on this site!

[Tom Galli]

Jjwb,

Welcome here.

Combination chemotherapy with carboplatin & etoposide and the immunotherapy drug atezolizumab (Tecentriq) is a relatively new therapy, and it is novel for small cell lung cancer (SCLC). Primary shrinkage is a good result and an indication the therapy is working. Is the primary tumor the only tumor she has? If so, adding precision radiation (SBRT, SABR, IGRT) can be a good way to eliminate the reluctant primary. 

While chemotherapy is effective, radiation always works. It is a sure-kill treatment, especially when administered using precision methods. This part of Lung Cancer 101 has information on radiation therapy used in lung cancer. I'm a fan. I had an uncooperative tumor in my lung that persisted despite multiple cycles of chemotherapy. Three short sessions of precision radiation (my treatment was SBRT) and the tumor was eliminated. That was in March 2007 and I've been NED (no evidence of disease) since.

I do hope radiation eliminates your wife's tumor.

Stay the course.

Tom

[Jjwb]

Hi Tom,

Many thanks for this very helpful information. My wife has a primary lung tumor that has shrunk with chemo/immuno. She also has lymph node involvement and small lesions on her spine that don’t appear to have been changed by chemo/immuno. The radiation oncologist has indicated that these will all be targeted during ten sessions of radiation.

We are hopeful that radiation will continue her positive progress.

Thanks again and best wishes,

John

[MomSCLC]

I believe there is some data showing possible synergy between radiation and immunotherapy for SCLC. My mom had thoracic radiation + immuno and had a 50% reduction in the primary lung mass and substantial reduction in lymph node. I hope everything goes well for you. Take care.

[Karen_L]

 

On 6/26/2023 at 6:25 AM, MomSCLC said:

I believe there is some data showing possible synergy between radiation and immunotherapy

My oncology radiologist is actually researching this synergy. She's pretty excited about it.