TRIDENT: Low-Dose RT Plus PD‑1 in Advanced NSCLC Optimal ways to combine radiotherapy with immune checkpoint blockade in advanced non–small cell lung cancer (NSCLC) remain uncertain, particularly for patients with bulky, heterogeneous disease. In the phase I TRIDENT regimen, 29 treatment‑naive, PD‑L1–positive patients with advanced NSCLC received a triple‑modality approach: immunomodulatory low‑dose radiotherapy (LDRT) to large tumor masses, immunogenic high‑dose radiotherapy (HDRT) to smaller lesions, and systemic PD‑1 blockade.
This strategy yielded a median overall survival of 51.3 months (95% CI 20.7–not reached), notably longer than contemporary (chemo)immunotherapy benchmarks, and the survival signal was corroborated in an independent real‑world cohort of 97 advanced lung cancer patients treated with a similar approach (median OS 41.5 months; 95% CI 26.3–63.7). Mechanistic…
