Formal discussant Johan F. Vansteenkiste, MD, PhD, Professor of Internal Medicine at University Hospital KU, Leuven, Belgium, was also enthusiastic about the findings in the concurrent chemoradiotherapy arm, and believes that a confirmatory trial should be done.

“Does the promise of immunotherapy meet reality? It starts to in START. The study delivers clinically relevant results,” Dr. Vansteenkiste said.

A confirmatory trial should be designed to address the potential issues in START, he said. Such a trial would include patient registration at the start of treatment so they can be followed, homogeneous contemporary concurrent stage III treatment, extensive biomarker research, and translational research on radiotherapy-immunotherapy links, he continued. ■

Disclosure: Dr. Vansteenkiste has been a consultant or advisor for GlaxoSmithKline, Lilly, and Merck Serono.