Local Consolidative Therapy After Dual Immunotherapy Fizzles in Metastatic NSCLC

Adding local consolidative therapy (radiotherapy or surgery) after 12 weeks of induction nivolumab plus ipilimumab did not prolong survival in metastatic non-small cell lung cancer: in the phase 3 LONESTAR trial median overall survival was 52.8 months with dual immunotherapy alone versus 43.2 months with added local therapy. No advantage was seen in progression-free survival or in the oligometastatic subgroup, where consolidation had been expected to help most. Investigators observed markedly lower absolute lymphocyte counts when systemic therapy resumed in patients who had undergone local therapy. Results were presented at WCLC 2026; the trial was single-centre and open-label, which limits the strength of the conclusions.