Phase 2 nivolumab PD‑1 inhibitor + hypofractionated ablative RT vs docetaxel chemo

University of Chicago is running a randomized Phase 2 study testing whether adding hypofractionated ablative external-beam radiotherapy (EBRT) to continued immune checkpoint inhibition can improve outcomes in metastatic or relapsed NSCLC that has progressed after prior immunotherapy-based treatment. Patients are randomized to (1) investigator’s-choice immunotherapy plus focused high-dose radiation to selected lesion(s) versus (2) investigator’s-choice standard chemotherapy. The immunotherapy backbone can include PD-1/PD-L1–pathway agents (including Bristol Myers Squibb’s nivolumab, a PD-1–blocking monoclonal antibody) and may allow other standard checkpoint options per protocol; the comparison arm includes agents such as docetaxel (a microtubule inhibitor from the taxane class). The scientific angle is an “oligoprogressive/resistant-clone” strategy: use local RT to debulk or immunologically “re-prime” while maintaining systemic immune pressure, potentially extending disease control beyond what chemo alone achieves after ICI progression. Today’s care after progression on first-line chemo‑immunotherapy is typically single-agent chemo (often docetaxel ± ramucirumab depending on setting), later-line agents, and palliative RT for symptoms; this trial tests whether RT + continued ICI can outperform that standard second-line switch.