Lattice SF-SBRT + Toripalimab/Chemo Drives 95% MPR in Resectable NSCLC

Lattice spatially fractionated SBRT delivers a single preoperative radiation fraction with a 12 Gy peak and <4 Gy valley, here combined with toripalimab, a PD-1 antibody, plus platinum-doublet chemotherapy in a prospective Phase 2 neoadjuvant study for resectable stage IIA–IIIB NSCLC (NCT06293690). Among 20/20 patients completing neoadjuvant therapy and surgery, R0 resection was 100%, MPR was 95% (19/20), pCR was 55% (11/20), ORR was 100%, and nodal downstaging to ypN0 occurred in 82.4% of patients with baseline nodal disease. Grade 3–4 TRAEs occurred in 15% with no grade ≥2 radiation pneumonitis, while the pCR rate is numerically above CheckMate-816 nivolumab+chemo (24%) and KEYNOTE-671 perioperative pembrolizumab+chemo (18.1%).