Advanced NSCLC: add microwave ablation for better survival

  • Wei Z & al.
  • Eur Radiol
  • 14 Feb 2020

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with advanced NSCLC who received microwave ablation (MWA) plus chemotherapy have better survival outcomes than those treated with chemotherapy alone, with tolerable adverse events (AEs).

Why this matters

  • Although platinum-based doublet chemotherapy is the standard first-line treatment for patients with NSCLC without sensitizing mutations or high program death-ligand 1, studies suggest that chemotherapy alone has reached a therapeutic plateau.

Study design

  • Multicenter, randomized, controlled, open-label, phase 3 trial.
  • Patients with advanced NSCLC received MWA followed by chemotherapy (n=148) or chemotherapy alone (n=145).
  • Funding: National Health and Family Planning Commission of the People’s Republic of China; others.

Key results

  • Median PFS was significantly better in the MWA group:
    • 10.3 vs 4.9 months (HR, 0.44; P<.0001>
  • Median OS was significantly better in the MWA group:
    • Not reached vs 12.4 months (HR, 0.38; P<.0001>
  • Objective response rate was similar between groups.
  • 89% of the MWA group achieved complete ablation, with local progression in 27 patients.
  • Overall incidence of AEs was similar between groups.
  • 76% of MWA group reported ablation-related complications, 20% of which were severe.
  • No treatment-related deaths in either group.

Limitations

  • Gene mutation status was unknown for most patients.