Single-center phase 2 trial of SBRT plus atezolizumab and tiragolumab in treatment-naïve patients with advanced non-small cell lung cancer

The phase 2 SKYROCKET trial at Yonsei University (Seoul, South Korea) evaluated the combination of stereotactic body radiotherapy (SBRT) with atezolizumab and tiragolumab for treatment-naïve patients with PD-L1-positive advanced non-small cell lung cancer (aNSCLC). Forty-one patients received SBRT to all metastatic sites and subsequently received 3-week cycles of atezolizumab and tiragolumab. The primary endpoint was investigator-assessed progression-free survival from the start of SBRT. At a median duration of follow-up of 9.8 months, median PFS was 9.3 months (95% CI 6.0-NR). No new safety signals were observed. CD8 progenitor-exhausted cells markedly expanded after treatment. CD4 regulatory T cells were reduced in the group with clinical benefit but increased in the group with no clinical benefit. The authors conclude that SBRT followed by atezolizumab plus tiragolumab showed encouraging clinical activity with manageable safety in PD-L1-positive aNSCLC.