{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:10:49Z","timestamp":1793502649565,"version":"4.5.0"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009812","name":"Chinese Society of Clinical Oncology","doi-asserted-by":"publisher","award":["Y-BMS2019-082"],"award-info":[{"award-number":["Y-BMS2019-082"]}],"id":[{"id":"10.13039\/501100009812","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Retrospective evidence indicated potential survival benefit of consolidative stereotactic radiotherapy (SRT) in patients with metastatic driver mutation-negative non-small cell lung cancer (NSCLC) harboring oligo-residual disease (ORD) after effective immune checkpoint inhibitor treatment. However, prospective data about consolidative SRT in this disease population after first-line chemoimmunotherapy remains scarce.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and findings<\/jats:title>\n<jats:p>From March 2021 to March 2023, 59 patients (94.92% males) with metastatic driver mutation-negative NSCLC harboring ORD after effective first-line chemoimmunotherapy were enrolled in this single-arm, phase 2 trial (NCT04767009), which was conducted at Fudan University Shanghai Cancer Center, Shanghai, China. The median (interquartile range) age was 64 (57,71) years. All of the patients received extracranial and\/or cranial SRT covering all of the oligo-residual lesions, without holding the maintenance systemic therapy during SRT. The most common sites targeted by consolidative SRT included the lung (<jats:italic>n<\/jats:italic>\u2009=\u200930), lymph nodes (<jats:italic>n<\/jats:italic>\u2009=\u200926), bone (<jats:italic>n<\/jats:italic>\u2009=\u200922), and brain (<jats:italic>n<\/jats:italic>\u2009=\u200922). All efficacy and safety analyses followed the intention-to-treat principle with all 59 enrolled patients included. No patient was lost to follow-up. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS) and treatment-related adverse events (TRAEs). With a median follow-up of 14.8 months, the median PFS was 29.0 (90% CI [13.97, Not Reach]) months, meeting the primary endpoint. The 2-year OS rate was 88.9% (95% CI [75.9%,100%]). TRAEs of any grade and grade \u22653 occurred in 58 (98.31%) and 13 (22.03%) patients, respectively. Moreover, a prespecified propensity score-matched comparison was conducted with a contemporary cohort of patients who developed ORD but received systematic therapy alone, which found that incorporating consolidative SRT was associated with prolonged PFS (adjusted HR 0.286, <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009&lt;\u20090.001) and OS (adjusted HR 0.229, <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009=\u20090.023). The main methodological limitation of this single-arm trial is its inability to establish causal relationships and the findings require validation in randomized controlled trials.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Consolidative SRT was associated with prolonged PFS and generally acceptable toxicities in first-line chemoimmunotherapy-treated patients with metastatic NSCLC harboring ORD, supported by propensity-matched comparisons with a contemporary cohort.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pmed.1004680","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T17:24:40Z","timestamp":1754069080000},"page":"e1004680","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Consolidative stereotactic radiotherapy for oligo-residual non-small cell lung cancer after first-line chemoimmunotherapy: A 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China"],"prefix":"10.1371","volume":"22","author":[{"given":"Hongru","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4184-7844","authenticated-orcid":true,"given":"Fei","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1630-0388","authenticated-orcid":true,"given":"Xiao","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhua","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yechun","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zezhou","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4745-6895","authenticated-orcid":true,"given":"Zhiyong","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3113-2586","authenticated-orcid":true,"given":"Jianjiao","family":"Ni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7537-3619","authenticated-orcid":true,"given":"Zhengfei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"issue":"11","key":"pmed.1004680.ref001","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1200\/JCO.22.01990","article-title":"Pembrolizumab 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