CHISELing a path forward in the treatment of early-stage non-small-cell lung cancer

Differentiating between these two scenarios in advance, before randomised controlled trials, is often impossible. [...]even when randomised controlled trials are launched, a large proportion of them fail, leaving us without a high level of evidence despite enormous efforts.1 Even successful trials c...

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Bibliographic Details
Published in:The lancet oncology 2019-04, Vol.20 (4), p.461-463
Main Authors: AlShafa, Faiez, Palma, David
Format: Article
Language:English
Subjects:
Cell death
Clinical medicine
Drug dosages
Immunotherapy
Lung cancer
Non-small cell lung carcinoma
Radiation therapy
Surgery
Tumors
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Summary:Differentiating between these two scenarios in advance, before randomised controlled trials, is often impossible. [...]even when randomised controlled trials are launched, a large proportion of them fail, leaving us without a high level of evidence despite enormous efforts.1 Even successful trials can be irrelevant if a technology has drastically improved since the trial was launched. CHISEL tested the effect of stereotactic ablative radiotherapy (SABR) in early-stage non-small-cell lung cancer (NSCLC) and compared the therapy with older radiotherapy techniques. Tumour cell death induced by SABR can trigger innate immunity, increase recruitment of immune cells, and activate the body's adaptive immunity.8 Perhaps the immune-stimulatory effects of SABR in conjunction with immunotherapy will bring advances in the treatment of early-stage NSCLC; this combined treatment will be tested in upcoming randomised controlled trials.
ISSN:1470-2045
1474-5488
DOI:10.1016/S1470-2045(18)30953-7