Fabio Ynoe de Moraes: Precision RT + Targeted Therapy in Inoperable Stage I–III NSCLC – The Next Frontier?
Fabio Ynoe de Moraes, Associate Professor at Queen’s University, shared a post on LinkedIn:
“Precision RT + Targeted Therapy in Inoperable Stage I–III NSCLC: The Next Frontier?
A new IASLC ART review highlights a clear biological rationale and emerging trial evidence for combining targeted therapies (e.g., EGFR/ALK TKIs) with radiotherapy in inoperable early‑stage and locally advanced NSCLC.
The LAURA phase III trial is a practice‑changer: adjuvant osimertinib after chemoradiotherapy extended median PFS to 39.1 months vs. 5.6 months.
Key clinical practice implications:
- Test early: Molecular profiling in stage I–III NSCLC should be standard before MDT discussion.
- Select smartly: Targeted therapy benefits are mutation‑specific—most data exist for EGFR, with ALK, RET, and others under study.
- Sequence strategically: Neoadjuvant, concurrent, and adjuvant approaches have distinct biological rationales and toxicity profiles.
- Monitor safety: Concurrent TKI + RT may increase pneumonitis risk—timing matters.
Plan for the CNS: Agents with strong brain penetration reduce intracranial relapse risk.
Methodology: This was a structured narrative review across PubMed, EMBASE, and ClinicalTrials.gov, with trial tables summarizing efficacy, toxicity, and design quality—critical for translating findings into real‑world practice.
Final message: Early molecular testing, thoughtful patient selection, and trial‑informed sequencing can help bring precision medicine into the curative‑intent radiotherapy setting for NSCLC.”
Title: Emerging Role of Targeted Therapies Combined With Radiotherapy in Inoperable Stages I to III NSCLC: A Review From the IASLC ART Subcommittee
Authors: Sarah Bowen Jones, Clara Chan, Andrea Filippi, Ken Harada, Alexander Louie, Colin Lindsay, Ernest Nadal, Pablo Munoz Schuffenegger, David Woolf, Corinne Faivre-Finn
You can read the Full Article in the Journal of Thoracic Oncology.
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