Overview

• Across a cohort of patients with limited-stage small cell lung cancer treated with chemoradiotherapy, adding consolidation immune checkpoint inhibitors improved overall survival versus chemoradiotherapy alone (hazard ratio 0.41; p=0.031).
• Patients who were ctDNA-positive after induction chemotherapy experienced significant progression-free and overall survival benefits from consolidation immunotherapy, whereas ctDNA-negative patients did not.
• ctDNA measured at the post-induction timepoint was a stronger predictor of immunotherapy benefit than measurements taken after radiotherapy.
• Serial testing indicated that maintaining ctDNA negativity during therapy was associated with a better prognosis.
• Investigators used ultra-deep next-generation sequencing with a 139-gene panel and time-dependent Cox models, and they recommended prospective, randomized trials to evaluate ctDNA-guided consolidation strategies.