Radiotherapy in patients with NSCLC developing progressive disease during immune checkpoint inhibition: Abscopal responses and survival

Kaufmann J, Trommer M, Rühle A, Lamrani A, Frei C, Mäurer M, Wurschi G, Jiang P, Ehret F, Baehr A, Hardt A, Bodensohn R, Käsmann L, Waltenberger M, Layer JP, Scafa D, Troost EG, Elkhamisy SA, Jazmati D, Popp I, Neppl S, Hagemeier A, Ferdinandus S (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Clinical and Translational Radiation Oncology Elsevier

Article Number: 101125

DOI: 10.1016/j.ctro.2026.101125

Abstract

ObjectiveIncreasing evidence suggests that RT and ICI have synergistic effects on anti-tumor immune response, and abscopal responses (AR) have been described more frequently with this combination. Here, we analyzed the frequency and factors associated with AR in NSCLC patients receiving ICI and RT.MethodsIn ARTIC (ARO 2022–10, DRKS00032390), a multicenter, retrospective study, patients treated with RT for progressive disease during or after receiving ICI were analyzed for abscopal benefit (AB) and overall survival (OS). Patients were grouped by non-irradiated lesion response; logistic and Cox regression were used to analyze factors linked to AR, AB, and OS.ResultsFifty-six patients from 13 centers with 137 non-irradiated lesions were analyzed. Most received hypofractionated or stereotactic RT. The most common RT sites were lung, bone, and brain. Thirty-three patients showed AB, with 15 patients developing an AR in at least one non-irradiated lesion. In the logistic regression analysis, older age was associated with a higher rate of AP (odds ratio (OR): 1.07, 95%-CI: 1.00–1.14; p = 0.05). Male sex showed a trend towards higher risk of AP (OR = 3.13; 95%- CI: 0.93–11.86; p = 0.075). In the multivariable Cox analysis, ECOG performance score at the start of RT (hazard ratio (HR): 0.29, 95%-CI: 0.12–0.69; p < 0.01) and oligometastatic disease (HR: 0.34, 95%-CI: 0.12–0.94; p = 0.039) were significantly associated with improved OS.ConclusionRT was able to induce AR in some NSCLC patients who were progressive under ICI, possibly delaying a switch in systemic treatment. AB was less frequent in older patients and in men.

Authors with CRIS profile

Allison Lamrani Department of Radiation Oncology Charlotte Frei Department of Radiation Oncology

Involved external institutions

Universitätsmedizin der Johannes Gutenberg-Universität Mainz DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE) Universitätsklinikum Freiburg DE Germany (DE) Universitätsklinikum Jena DE Germany (DE) Märkische Kliniken (Klinikum Lüdenscheid, Stadtklinik Werdohl) DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden DE Germany (DE) Universitätsklinikum Düsseldorf DE Germany (DE) Universitätsklinikum Köln DE Germany (DE) Centrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf (CIO ABCD) DE Germany (DE) Klinikum der Universität München (LMU Klinikum) DE Germany (DE) Klinikum rechts der Isar DE Germany (DE)

How to cite

APA:

Kaufmann, J., Trommer, M., Rühle, A., Lamrani, A., Frei, C., Mäurer, M.,... Ferdinandus, S. (2026). Radiotherapy in patients with NSCLC developing progressive disease during immune checkpoint inhibition: Abscopal responses and survival. Clinical and Translational Radiation Oncology. https://doi.org/10.1016/j.ctro.2026.101125

MLA:

Kaufmann, Justus, et al. "Radiotherapy in patients with NSCLC developing progressive disease during immune checkpoint inhibition: Abscopal responses and survival." Clinical and Translational Radiation Oncology (2026).

BibTeX: Download