Induction and consolidation atezolizumab with stereotactic body radiation therapy versus radiation alone in high-risk, early-stage non-small-cell lung cancer (SWOG/NRG S1914): a multicentre, open-label, superiority, phase 3, randomised controlled trial.

Adding atezolizumab to SBRT does not improve overall survival in high-risk, early-stage non-small-cell lung cancer, with 2-year survival at 82% in both groups.

• Why it matters: This work addresses the critical need to enhance treatment outcomes for patients with inoperable early-stage NSCLC at increased risk of recurrence, where current standard care offers limited survival benefits.
• What they did: A multicentre, phase 3 randomized trial enrolled 402 patients, comparing SBRT alone versus SBRT combined with up to eight cycles of atezolizumab, assessing overall survival and adverse events over a median follow-up of nearly 25 months.
• The result: The addition of atezolizumab showed no survival benefit (hazard ratio 1.04, p=0.58), but increased severe adverse events, indicating that combining immunotherapy with SBRT does not improve outcomes and may raise safety concerns.