20.500.12556/DiRROS-31848 Real-world treatment patterns and outcomes of chemo-immunotherapy with or without radiotherapy in extensive-stage small cell lung cancer the durvalumab expanded access cohort Real-world treatment patterns and outcomes of chemo-immunotherapy with or without radiotherapy in extensive-stage small cell lung cancer: the durvalumab expanded access cohort Purpose: To describe real-world treatment patterns and outcomes among patients with extensive-stage small cell lung cancer (ES-SCLC) treated with first-line chemotherapy plus durvalumab as in CASPIAN trial within Expanded Access Program, with a focus on the use and impact of consolidation (cRT) and salvage radiotherapy (sRT).Patients and methods: This retrospective, multicenter cohort study included patients with ES-SCLC treated with durvalumab plus platinum–etoposide between September 2019 and December 2022 across 11 academic centers in Israel, Poland, Portugal, and Slovenia. Patients characteristics, radiotherapy use, adverse events (AE), and outcomes were collected using a standardized form. Radiotherapy was categorized as cRT, sRT, or palliative RT (pRT). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan–Meier methods and compared using log-rank testing. Multivariable Cox regression evaluated predictors of survival.Results: A total of 133 patients were included (median age 65 years; 74% ECOG PS 0–1). Radiotherapy was administered to 58.6% of patients (cRT 28.2%, sRT 24.3%, pRT 47.4%). Median (m) PFS and mOS for the entire cohort were 6.9 months (m) and 15.9 m, respectively. Patients receiving cRT achieved the longest mPFS (11.7 m) and a mOS of 19.5 m; sRT was associated with an mOS of 20.4 m. Continuation of durvalumab beyond progression combined with RT was associated with improved survival (p = 0.024). Treatment-related AEs occurred in 38.3% of patients, immune-related toxicities were infrequent, and pneumonitis was rare.Conclusion: In this multinational real-world cohort, outcomes with first-line chemo-immunotherapy were consistent with CASPIAN trial. The addition of cRT or sRT appeared feasible, safe, and associated with clinically meaningful survival improvements. Prospective trials are needed to define optimal integration of radiotherapy with chemo-immunotherapy in ES-SCLC. chemo-IO consolidation radiotherapy salvage radiotherapy palliative radiotherapy ES-SCLC extensive-stage small cell lung cancer kemoimunoterapija konsolidacijska radioterapija reševalna radioterapija paliativna radioterapija razsejani drobnocelični rak pljuč true false true Frontiers Editorial Office Frontiers in oncology Angleški jezik Slovenski jezik © 2026 Janzic, Shalata, Unk, Terglav, Shirron, Daher, Moskovitz, Merimsky, Garrido, Lopes, Araujo, Shantzer, Gantz-Sorotsky, Rotem, Urban, Chmielewska, Barroso and Zer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Neznano 2026-08-11 12:54:35 2026-08-11 12:54:35 2026-08-12 03:44:49 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 31. 7. 2026; 9 str. [article no. ǂ1821628 Vol. 16 23 Jul 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2026-03-02 2026-07-03 2026-07-23 616.24-006:615.849 2234-943X 10.3389/fonc.2026.1821628 286540035 https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1821628/full 1 0df9369d-9573-11f1-af5a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=49484 RAZ_Janzic_Urska_2026.pdf RAZ_Janzic_Urska_2026.pdf 1 6E12F23A51D4551C490E8ECB980D7EBA a64416f37051e33f80443285198eca8e66d2808f084b5b959204d9c025d11584 d4af0768-9573-11f1-af5a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=49485 Univerzitetna klinika za pljučne bolezni in alergijo Golnik 0 0 0