Sequential radiotherapy and immunotherapy boosts survival for non-small cell lung cancer patients
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CANCER DIGEST – March 28, 2026 – Non-small cell lung cancer patients survived longer when treated with a sequence of radiation and immunotherapy compared to being treated with the two at the same time, according to a new clinical trial.
Led by Han Zhou, MD, PhD of the University of Hong Kong-Shenzhen Hospital, the researchers compared giving patients with advanced non-small cell lung cancer or those whose cancer that had not responded to treatment, radiation therapy followed by immunotherapy to giving the radiation and immunotherapy at the same time. Their results were published online March 26, 2026 in the journal JAMA Oncology.
Integrating immunotherapy with radiation has become focus of cancer treatment in recent years as doctors try to determine which combination is better than the other, and determining what combination produces the best outcomes. At the time of this trial no other researchers had compared sequential versus concurrent delivery of radiation and immunotherapy.
For the trial, concurrent radiation and immunotherapy was defined as starting immunotherapy on the first day of radiation treatments, and sequential strategy required starting immunotherapy within 42 days after completion or radiation therapy.
The clinical trial, called OCEANUS, involved 3,522 patients enrolled in the trial at 43 hospitals in Hong Kong between 2010 and 2021. Patients with advanced non-small lung cancer and patients who had been treated but did not respond to treatment were randomly assigned to receive radiation therapy and immunotherapy in one of two ways, either sequential, i.e. radiation followed by immunotherapy, or concurrent, receiving the radiation and immunotherapy at the same time.
The newly diagnosed patients treated sequentially had overall survival averaging 20.3 months compared to an overall survival of 16.0 months for those treated concurrently.
In the patients who had not responded to treatment, or those whose cancer was refractory to treatment, those treated sequentially survived a median of 11.2 months compared to 6.7 months for those treated concurrently.
The researchers concluded that sequential immunotherapy and radiation therapy was associated with improved survival in both patients newly diagnosed with advanced non-small lung cancer and patients who had not responded to previous treatment. They also emphasized the need for prospective trials to refine the optimal sequencing and combinations of therapy in advanced non-small cell lung cancer.
Source: JAMA Oncology
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