2 promising lung cancer radiation therapy findings from ASTRO 2026

New research presented in Boston at the 2026 American Society for Radiation Oncology (ASTRO) Annual Meeting highlights two approaches that could help personalize radiation treatment for people with non-small cell lung cancer (NSCLC). The findings looked at radiation therapy for older and frail adults with stage II–III NSCLC and the long-term benefits of combining radiation with immunotherapy for early-stage NSCLC. 

Together, the studies offer encouraging insights into how treatment can be tailored to improve outcomes while balancing side effects and quality of life.

1) Study supports tailored radiation treatment for older adults with NSCLC

For older adults with stage II–III NSCLC, standard treatments may be difficult to tolerate because of other health conditions or frailty. A study of more than 1,800 people found that radiation therapy alone was associated with meaningful survival, including in people aged 75 and older. Serious treatment-related side effects were uncommon, occurring in about 8% of patients, although these side effects had a greater impact on survival in older adults. Importantly, receiving a lower radiation dose wasn’t linked to shorter overall survival, suggesting that some older or frail patients may be able to receive a dose tailored to what they can safely tolerate. 

These findings are important because they support a more individualized approach to radiation therapy for older adults, balancing cancer treatment with safety and quality of life.

2) Combining immunotherapy and radiation may help prevent NSCLC from returning

A 6-year follow-up study suggests that adding the immunotherapy drug nivolumab to stereotactic ablative radiotherapy (SABR) may help some people with early-stage NSCLC live longer and remain cancer-free longer. At 6 years, 55% of people who received the combination remained free of cancer-related events, compared with 32% who received SABR alone, while overall survival was 69% versus 55%. This is important because SABR is already an effective treatment for people with early-stage NSCLC who can’t have surgery, but cancer can still return after treatment. Although adding immunotherapy caused more serious side effects, no cases of severe pneumonitis or grade 4 or higher toxicity were reported. 

While larger phase 3 trials are needed, these long-term results are encouraging and suggest that combining radiation with immunotherapy could offer a new way to reduce the risk of recurrence and improve long-term outcomes for some people with early-stage NSCLC.

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