C. Jillian Tsai, MD, PhD, Discussed Outcomes with SBRT in Lung and Breast Cancer


CancerNetwork® sat down with C. Jillian Tsai, MD, PhD, at the 2021 American Society for Radiation Oncology to talk about the use of stereotactic body radiation therapy to treat breast and lung cancer.

At the 2021 American Society for Radiation Oncology, CancerNetwork® spoke with C. Jillian Tsai, MD, PhD, a radiation oncologist from the Memorial Sloan Kettering Cancer Center, about the differences seen between patients with non–small cell lung cancer (NSCLC) and breast cancer following treatment with stereotactic body radiation therapy (SBRT). Notably, Tsai stated that patients in the lung cancer group, in particular, were more likely to respond to SBRT than the breast cancer group. She emphasized the importance of expanding the trial in order to better identify which subgroup of patients would most benefit from SBRT.


In this trial, we accrued both [patients] with NSCLC, and breast cancer. They all had oligoprogressive diseases, and they were randomized into 2 groups. One group would continue their standard of care therapy, per physician’s choice. Another group, [was given] up-front radiation therapy to the progressive sites—very targeted radiation—followed by the standard of care therapy. What we found was very interesting; if we look at the group as a whole, combining lung and breast, there is a significant difference. After giving patients SBRT, then targeted radiation to treat the progressive sites, these patients had a longer progression-free survival, compared with the standard of care group. When we separated the lung and breast [groups], looking at them [separately], the lung group was the group that was driving the result. There was a very substantial benefit of adding targeted SBRT radiation therapy to the oligoprogressive disease in the lung group, whereas in the breast cohort, there was really no difference.

There could be several different explanations [for these differences]. First, is that for the lung group, perhaps, maybe their previous lines of systemic therapies were different from the breast cohort. There could [also] be some synergy in their previous systemic therapy with radiation. Another reason could be just because the lung group really had a steadier state of disease with slow progressive disease over time. Whereas the breast patients might have already had multiple dormant pseudo-progressive sites that were not hot at the time of enrollment and randomization. All these other sites might eventually just progress regardless. We are looking into the exact details of these patients and their differences to hopefully find explanations.

We are hoping to expand the trial once we find a subgroup of patients who could potentially really benefit from the technique and hope to take it to a larger study to [examine] this further.


Tsai J, Yang T, Guttmann DM, et al. Consolidative use of radiotherapy to block (CURB) oligoprogression: Interim analysis of the first randomized study of stereotactic body radiotherapy in patients with oligoprogressive metastatic cancer of the lung and breast. Presented at 2021 American Society For Radiation Oncology; October 24-27 2021; Chicago IL. Abstract LBA-3.

Related Videos
Future analyses will look at durvalumab/olaparib for endometrial cancer populations with TP53 and POLE alterations, as well as those with estrogen receptor and progesterone receptor positivity.
Patients with mismatch repair proficient, newly diagnosed, advanced or recurrent endometrial cancer may have enhanced benefit with the addition of olaparib to durvalumab.
Those with breast cancer who have undergone implant-based reconstruction following mastectomy have similar outcomes with hypofractionated vs conventionally fractionated radiotherapy.
Common adverse effects following treatment with lenvatinib plus pembrolizumab in the phase 3 CLEAR study include diarrhea, hypertension, and fatigue, according to Thomas E. Hutson, DO, PharmD, FACP.
Lenvatinib in combination with pembrolizumab appears to raise no new safety signals in patients with advanced clear cell renal cell carcinoma after 4 years of follow-up in the phase 3 CLEAR study.
According to Thomas E. Hutson, DO, PharmD, FACP, 4-year follow-up data from the phase 3 CLEAR study confirm the maintained benefits of lenvatinib plus pembrolizumab in patients with advanced renal cell carcinoma.
Findings from the phase 3 MIRASOL trial support mirvetuximab soravtansine as a standard treatment option for platinum-resistant ovarian cancer, according to Ritu Salani, MD.
Rana R. McKay, MD discusses presentations of interest that were presented at the 2023 Kidney Cancer Research Summit, including a discussion on how PET imaging may identify which patients with renal cell carcinoma may respond to immunotherapy.
A better understanding of tumor biology may be necessary for identifying novel non-immunotherapy–based therapeutic strategies for patients with renal cell carcinoma, according to Rana R. McKay, MD.
Probiotics and other agents targeting fatty acid oxidation are also under evaluation as treatment options for patients with renal cell carcinoma, according to Rana R. McKay, MD.