Tom Newsom-Davis, Vice Chair, Multidisciplinary Clinical Sciences Committee at International Association for the Study of Lung Cancer, shared on X:
“Practice changing data from the SARON study at ESMO26 from Fiona McDonald, The Royal Marsden NHS Foundation Trust.
Herculean effort, run over 10 years.
Does adding radiotherapy to SACT in the immunotherapy era improve survival in synchronous oligometastatic NSCLC?
What do we know already?
- LCT improves outcomes in pre-immuno era and with AGA+ NSCLC
- More recently, no survival benefit with niv/ipi regimens (LONESTAR)
What does SARON add?
- Well designed, randomised, multicentre prospective study
- Comprehensive baseline assessments with PET and MRI
- Appropriate definition of OMD (1-5 sites)
- PFS benefit, and reduces progression at treated sites
- No OS benefit, and no reduction progression at new sites of disease
- No additional toxicity
Thoughts:
Great academic study.
Addresses important and relevant question.
Presumably parents have more metastases than we can detect, which then progress, losing OS benefit.
Patients must be informed of lack of OS benefit if LCT being considered.
Is LCT appropriate if OS not improved? (LCT in AGA+ NSCLC, and LCT in metachronous OMD not answered here).”
You can also read: SARON: Consolidation Radiotherapy Improves PFS but Not Overall Survival in Oligometastatic NSCLC
