OCEANUS was a retrospective cohort study from Hong Kong's public hospital system (43 hospitals, ~90% population coverage) that identified 335 patients with NSCLC who received a combination of immunotherapy and RT (iRT). Of these, 155 had newly diagnosed advanced NSCLC and 180 had refractory disease. In the newly diagnosed cohort, sequential iRT was associated with longer OS than concurrent iRT (20.3 vs 16.0 months). The effect appeared strongest among patients receiving definitive RT but was not significant for palliative RT. For refractory NSCLC, immunotherapy maintenance after RT nudged median OS from 6.7 to 11.2 months without reaching significance. There were some obvious limitations, though, including no PD-L1 data, no molecular profiling, and over half of newly diagnosed patients had unknown histologic subtype. This real-world cohort aligns with randomized trials like PACIFIC-2 that suggest little added value to concurrent iRT. | Zhou, JAMA Oncol 2026
