The advent of immune checkpoint inhibition (ICI) concurrent to and following chemotherapy for extensive stage small cell lung cancer (ES-SCLC) represents the biggest advancement this disease has seen in a generation. It’s too bad, then, that the landmark trials didn’t include standard consolidative thoracic radiation in their trial designs. We are left with these consensus guidelines from our northern neighbors coming from an even split of Canadian med oncs and rad oncs relying on available data, combined experience, and expert opinion. In case there was any question, they agree all patients with a response to chemo-immunotherapy, good performance status, and limited metastatic disease have a discussion of consolidative radiation that can be administered during maintenance ICI. This same population should also have a discussion of the risks / benefits of PCI with those opting for surveillance undergoing routine interval MRI brains for at least two years following induction chemo-immunotherapy. Again, PCI (or any brain irradiation) can be safely delivered during maintenance ICI. | Sun, Lung Cancer 2023
