ASCO expert Corey Speers, MD, PhD, Professor of Radiation Oncology at the University Hospitals Seidman Cancer Center, Cleveland, provided thoughts on the IELSG37 trial at a press briefing. “The investigators should be congratulated for running the largest ever trial in primary mediastinal B-cell lymphoma. This is an achievement in and of itself. And the very low event rate in the study—lower than expected—is encouraging for patients and physicians who treat this cancer. This incredible study fits very nicely into the ASCO 2023 Annual Meeting theme of de-escalation of therapy and the idea that more is not always better, and less may be more,” he commented.
Dr. Speers continued: “In the study, the omission of radiotherapy seemed to be safe, and more than 100 patients needed to be treated for just 1 patient to benefit—that is also very encouraging,” he added. “As was noted, this disease primarily affects young women, and although radiotherapy has never been safer than it is today, it still puts patients at a small risk for second malignancies, including breast cancer, in later decades. These patients are likely to live many more decades, so anything we can do to eliminate the side effects of therapy is a win for our field and a win for these patients and their families.”
Corey Speers, MD, PhD
Julie R. Gralow, MD, FACP, FASCO
Press briefing moderator Julie R. Gralow, MD, FACP, FASCO, ASCO Chief Medical Officer and Executive Vice President, further commented on the study’s findings. “A 3-year overall survival rate of 99%: It’s hard to do better than that…. I applaud the investigators and think these findings will change the standard of care…. It’s now time to reduce the toxicities associated with our treatments. We are getting great results with de-escalation of therapy. Our ASCO vision is a world where cancer is prevented or cured, and every survivor is healthy.” Dr. Gralow is Professor of Medical Oncology and Director of Breast Medical Oncology at the University of Washington, Fred Hutchinson Cancer Research Center, and the Seattle Cancer Care Alliance.
DISCLOSURE: Dr. Speers and Dr. Gralow reported no conflicts of interest.
In the largest prospective study of patients with primary mediastinal B-cell lymphoma, radiation therapy was omitted in complete responders to immunochemotherapy without compromising outcomes. These findings were presented at the 2023 ASCO Annual Meeting.1
“Mediastinal radiotherapy may be safely...