Chemoradiation ± Atezolizumab in Limited-Stage Small Cell Lung Cancer: Results of NRG Oncology/Alliance LU005
Recommended Citation
Higgins KA, Hu C, Ross HJ, Jabbour SK, Kozono DE, Owonikoko TK, Ritter TA, Williams TM, Welsh J, Simko JP, Movsas B, Xiao C, Kaira K, Gupta AK, Mohindra P, Dib EG, Brownstein J, Chun S, Kuzma CS, Kotecha R, Onitilo AA, Chen Y, Stinchcombe TE, Wang X, Paulus R, and Bradley JD. Chemoradiation ± Atezolizumab in Limited-Stage Small Cell Lung Cancer: Results of NRG Oncology/Alliance LU005. J Clin Oncol 2026;44(8):630-640.
Document Type
Article
Publication Date
3-10-2026
Publication Title
Journal of clinical oncology
Keywords
Humans, Small Cell Lung Carcinoma, Male, Lung Neoplasms, Female, Middle Aged, Aged, Antibodies, Monoclonal, Humanized, Antineoplastic Combined Chemotherapy Protocols, Chemoradiotherapy, Neoplasm Staging, Adult, Carboplatin
Abstract
PURPOSE: NRG Oncology/Alliance LU005 (ClinicalTrials.gov identifier: NCT03811002) tested the addition of atezolizumab to concurrent chemoradiation (CRT) in this open-label, phase III international trial.
METHODS: Patients with limited-stage small cell lung cancer (LS-SCLC), stage Tx-IV, N0-3, and M0 with Eastern Cooperative Group performance status (PS) 0-2 received one cycle of chemotherapy (platinum/etoposide) before study registration and were randomly assigned to CRT alone versus CRT plus concurrent and adjuvant atezolizumab, 1,200 mg once daily, every 3 weeks until investigator-assessed progression or intolerable side effects for a maximum of 17 cycles. Patients were stratified by choice of chemotherapy (cisplatin v carboplatin), radiation fractionation schedule (66 Gy once daily v 45 Gy twice daily), sex, and PS (0/1 v 2). The primary end point was overall survival (OS). Secondary end points included investigator-assessed progression-free survival (PFS), objective response rate, local control, and distant-metastasis-free survival (DMFS).
RESULTS: patients were randomly assigned from May 2019 to December 2023. The median OS was 36.1 months (95% CI, 28.1 to 42.5) for the CRT-alone arm and 31.1 months (95% CI, 28.5 to 44.7) for the CRT + atezolizumab arm, respectively (hazard ratio [HR], 1.03 [95% CI, 0.80 to 1.32]). The median PFS was 11.4 months (95% CI, 10.3 to 13.2) for the CRT-alone arm and 12.1 months (95% CI, 10.9 to 15.2) for the CRT + atezolizumab arm, respectively (HR, 0.98 [95% CI, 0.79 to 1.22]). The median DMFS was 13.0 months (95% CI, 11.3 to 18.2) for the CRT-alone arm and 16.8 months (95% CI, 12.1 to 21.6) for the CRT + atezolizumab arm (HR, 0.96 [95% CI, 0.76 to 1.21]). No unexpected safety signals with concurrent atezolizumab were observed.
CONCLUSION: Concurrent and adjuvant atezolizumab with chemoradiation did not improve survival in patients with LS-SCLC.
Medical Subject Headings
Humans; Small Cell Lung Carcinoma; Male; Lung Neoplasms; Female; Middle Aged; Aged; Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Chemoradiotherapy; Neoplasm Staging; Adult; Carboplatin
PubMed ID
41529214
ePublication
ePub ahead of print
Volume
44
Issue
8
First Page
630
Last Page
640
