S812
Clinical - Lung
ESTRO 2026
did not demonstrate a survival difference between surgery and chemoradiotherapy (CRT) within multimodal regimens, these studies predated modern staging techniques and immunotherapy. Durvalumab, an anti-PD-L1 antibody, has shown significant survival benefit after CRT in unresectable stage III NSCLC. The InDuRanS trial investigates whether surgery or CRT provides superior event-free survival (EFS) when integrated into a multimodal treatment sequence with induction immunochemotherapy and consolidation durvalumab. Material/Methods: InDuRanS (ARO-2024-12, NCT06810609) is a multicenter, open-label, prospective randomized phase II trial across approximately 10 German centers. A total of 176 patients with resectable or borderline resectable stage IIIA/B (N2) NSCLC (EGFRm − , ALK − ) will be enrolled. All participants receive three cycles of induction immunochemotherapy consisting of durvalumab (1,500 mg q3w) combined with platinum- paclitaxel. After PET-based restaging, those with persisting resectable disease are randomized 1:1 to either surgery (Arm A) or definitive CRT (60 − 70 Gy in conventional fractionation with two cycles of platinum- vinorelbine; Arm B), followed by consolidation durvalumab (1,500 mg q4w) for up to 12 months. The primary endpoint is 2-year EFS after randomization. Secondary endpoints include overall survival, progression-free survival, safety and tolerability, surgical outcomes, and quality of life (EORTC QLQ- C30/LC13). Exploratory objectives include radiomics, plasma proteomics, ctDNA, and immune profiling. Results: The trial plans to randomize 158 evaluable patients. The expected 2-year EFS is approximately 63% for the surgery arm based on prior data with neoadjuvant chemoimmunotherapy. Interim safety analyses are planned after treatment completion of the first ten randomized participants. The trial is currently active and enrolling patients. Conclusion: InDuRanS will prospectively evaluate, for the first time, the comparative efficacy and safety of surgery versus CRT after induction durvalumab-based immunochemotherapy in (borderline) resectable stage III NSCLC. The results aim to guide optimal multimodal strategies in the modern immunotherapy era for patients with locally advanced NSCLC. Keywords: NSCLC, durvalumab, immunochemotherapy
Conclusion: Compared to VMAT, IMPT for thymic tumours resulted in substantial reductions (45-60%) in mean doses to organs of interest. When guided by model based selection, these dosimetric advantages translated into clinically meaningful reductions in predicted side effects, supporting the value of this approach for optimizing treatment selection in this patient population. Keywords: Thymoma, IMPT immunochemotherapy followed by surgery or chemoradiation and consolidation durvalumab in stage III NSCLC Eleni Gkika 1 , Cornelius Waller 2 , Cas Stefaan Dejonckheere 1 , Gerald Schmid-Bindert 3 , Joachim Schmidt 4 , Peter Brossart 5 , Ernst Rodermann 6 , Anne Sofie Schiefer 7 , Marc Münter 7 , Nils Henrik Nicolay 8 , Anca Ligia Grosu 9 , Andreas Rimner 9 , Severin Schmid 10 1 Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany. 2 Department of Medical Oncology, University Hospital Freiburg, Freiburg, Germany. 3 AstraZeneca, -, -, Germany. 4 Department of Thoracic Surgery, University Hospital Bonn, Bonn, Germany. 5 Department of Medical Oncology, University Hospital Bonn, Bonn, Germany. Digital Poster 3215 InDuRanS: Randomized trial on induction 6 Medical Oncology, Rhein-Sieg, Bonn, Germany. 7 Department of Radiation Oncology, University Hospital Stuttgart, Stuttgart, Germany. 8 Department of Radiation Oncology, University Hospital Leipzig, Leipzig, Germany. 9 Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany. 10 Department of Thoracic Surgery, University Hospital Freiburg, Freiburg, Germany Purpose/Objective: The optimal local treatment strategy for resectable stage IIIA/B (N2) non-small-cell lung cancer (NSCLC) remains undefined. While previous randomized trials
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