Hypofractionated Radiation Therapy to Improve Immunotherapy Response in Non-Small Cell Lung Cancer

Radiation therapy will be administered in 3 or 5 fractions over 3-10 days, at a recommended dose of 8-15 Gy per fraction for 3 total fractions (total dose 24-45 Gy) or 6-10 Gy per fraction for 5 total fractions (total dose 30-50 Gy)

"Immune checkpoint inhibitors that are FDA approved for use in patients with metastatic NSCLC will be acceptable for use concurrently with radiotherapy in this trial. The choice of agents will be at the treating medical oncologist's discretion, and include:~* Nivolumab 240mg or 3 mg/kg once every 2 weeks (14 day cycle)~* Pembrolizumab 200mg or 2 mg/kg once every 3 weeks (21 day cycle)~* Atezolizumab 1200 mg once every 3 weeks (21 day cycle)~These agents should be continued per standard of care until either disease progression or unacceptable toxicity."