Top KOLs Discussing SARON
SARON Key Slides & Visuals
ESMO 2026 slides
| SACT + RT (n=70) | SACT alone (n=70) | HR (95% CI), P | |
|---|---|---|---|
| Median OS, months | 31.0 | 28.0 | 0.99 (0.63–1.55), P = 0.95 |
| Number at risk at 12 / 24 / 36 months | 55 / 33 / 21 | 51 / 38 / 15 | — |
Same slides also posted by @AdamJanuszewski, @Alfdoc2.
| SACT + RT (n=70) | SACT alone (n=70) | HR (95% CI), P | |
|---|---|---|---|
| Median PFS, months | 13.9 | 8.9 | 0.64 (0.43–0.95), P = 0.03 |
| Number at risk at 12 / 24 / 36 months | 38 / 21 / 11 | 26 / 12 / 6 | — |
Same slides also posted by @TommyJohn00, @HHorinouchi.
Same slides also posted by @TommyJohn00.
| SACT + RT (n=70) | SACT alone (n=70) | Gray’s test | |
|---|---|---|---|
| Progression at sites of initial disease, 12 months | 13.0% | 39.5% | P < 0.001 |
| Progression at new sites of disease, 12 months | 36.2% | 32.3% | P = 0.28 |
Same slides also posted by @HHorinouchi.
Same slides also posted by @Alfdoc2, @HHorinouchi.
KOL-Made Infographics
Summary graphics designed or shared by physicians (not conference slides). Values are as the authors drew them. Click to enlarge.
@jryckman3
@jryckman3
@jryckman3
@daakhsaab
@LatinamdSARON conversations on X
Context: the ESMO 2026 design slide and the 2613O abstract describe SARON as a randomised phase II trial.
Physician reactions to SARON
🌍 @myESMO 2026 | Madrid, Spain Inspiring days at #ESMO2026, with exciting developments for the #LungCancer community! 🔬 1/5 🧬 Major attention was drawn to DeLLphi-305, bringing promising news for patients with SCLC, alongside SAFFRON and OptiTROP-Lung06. 2/5 📊 The SARON trial showed improved progression-free survival in driver-negative oligometastatic NSCLC with radiotherapy (13.9 vs. 8.9 months), although no overall survival benefit was observed. Important findings presented by @fifimcdrmh 3/5 🔪 Exciting developments for the surgical community! CTONG 1804 reported #conversion rates approaching 50%. @DoctorJSpicer presented findings from MDT-BRIDGE, highlighting the potential of ctDNA clearance as a predictor of pathological complete response (pCR) in resectable and borderline resectable NSCLC. ctDNA clearance at C2D1 showed an 83.3% positive predictive value for pCR, providing valuable insights into treatment response. 4/5 🧬 De-escalation of immunotherapy in advanced or metastatic cancer was another key topic. While reducing treatment intensity may improve quality of life and minimise toxicity, further evidence is needed before routine implementation. 5/5 🎤 Delighted to contribute to the early-stage track alongside @MarianaBrandao0 , @stephanieplsaw , Jan von der Thüsen and Suresh Senan, discussing: “Multistation N2 (N2b), T4 lesions, and pneumonectomy: Time to reconsider induction chemo-immunotherapy?” A valuable congress filled with scientific exchange, innovation and new perspectives for thoracic oncology! #ESMO #ThoracicSurgery #LungCancer #Oncology #Immunotherapy #ClinicalTrials #USZ
5. SARON: synchronous oligometastatic, actionable-genomic-alteration–negative NSCLC, adding LCT to systemic therapy. RT improved median PFS - 13.9m Vs 8.9m. *No OS benefit*, but no extra serious side effects. Consider LCT in fitter patients with lower metastatic burden #ESMO26
Item 5 of a numbered thread of ESMO 2026 take-home messages for NHS lung cancer teams.
Practice changing data from the SARON study at #ESMO26 from @fifimcdrmh @royalmarsdenNHS 👏 Herculean effort, run over 10 years 🤔 Does adding radiotherapy to SACT in the immunotherapy era improve survival in synchronous oligometastatic NSCLC? What do we know already? ✅ LCT improves outcomes in pre-immuno era & with AGA+ NSCLC ❌ More recently, no survival benefit with niv/ipi regimens (LONESTAR) What does SARON add? ✅ Well designed, randomised, multicentre prospective study ✅ Comprehensive baseline assessments with PET and MRI ✅ Appropriate definition of OMD (1-5 sites) ✅ PFS benefit, and reduces progression at treated sites ❌ No OS benefit, and no reduction progression at new sites of disease ✅ No additional toxicity Thoughts: 🤔 Great academic 🇬🇧 study 👏 🤔 Addresses important & relevant question 🤔 Presumably parents have more metastases than we can detect, which then progress, losing OS benefit 🤔 Patients must be informed of lack of OS benefit if LCT being considered 🤔 Is LCT appropriate if OS not improved? (❗️LCT in AGA+ NSCLC, and LCT in metachronous OMD not answered here) #LCSM
🇪🇸 #ESMO26 Top Lung Abstracts | SARON 🫁 ☢️In synchronous oligometastatic, driver-negative #NSCLC, adding consolidative RT to systemic therapy improved PFS (13.9 vs 8.9 months; HR 0.64) and local control. ❗But no OS benefit (HR 0.99; p=0.95). Better disease control doesn’t always translate into longer survival! 🔬 #LungCancer #LCSM
Better local control. Longer PFS. No demonstrated OS benefit. SARON randomized 140 patients with synchronous oligometastatic NSCLC without actionable genomic alterations to systemic therapy ± radical radiotherapy. • Primary OS endpoint NOT met: HR 0.99; P=0.95 • PFS: 13.9 vs 8.9 months; HR 0.64; P=0.03 • 12-month local failure: 13.0% vs 39.5% • Grade ≥3 AEs: 28.6% in both groups Importantly, 40% received chemotherapy alone. Which patients gain enough from consolidation RT to justify treatment—and how does modern systemic therapy change that selection? @StephenVLiu @CharuAggarwalMD @myESMO @OncoAlert #SARON #ESMO26 #LCSM #RadOnc
🎯 #ESMO26 | Excellent discussion by @benlevylungdoc on SARON and PERSEE! Two trials, two important lessons for advanced NSCLC. 🔹 SARON: Consolidative radiotherapy improved PFS and local disease control in oligo metastatic NSCLC, but no OS benefit (HR 0.99). 🔹 PERSEE: Pembrolizumab + chemo met its primary endpoint PFS but not OS though numerically better (not powered for OS) in PD-L1 ≥50% NSCLC. Key messages from @benlevylungdoc : • Oligometastatic disease needs better biological definition, beyond the number of lesions. • Treatment intensification should be guided by better patient selection. • More treatment does not automatically mean better outcomes! - Lower threshold to add chemo to pembro in PD-L1 >50% 👏 A thoughtful discussion with practical implications for our clinics. #ESMOAmbassador #LungCancer #NSCLC
Fantastic discussion from @benlevylungdoc. On SARON, tumour heterogeneity may explain negative results. On PERSEE, agree that it is practice changing and clean data. Where do ADCs fit when design removes chemo? Also can we use ctDNA and adaptive design? #LCSM #ESMO26
🚨 #ESMO26 | SARON: Better PFS, but NO overall survival benefit! @fifimcdrmh presents the randomized phase II SAFRON trial in synchronous oligometastatic, driver-negative NSCLC. 📊 Median OS: 🔹 SACT alone: 28.0 months 🔹 SACT + consolidative RT: 31.0 months 🔹 HR 0.99 (95% CI 0.63–1.55), p=0.95 ✅ Better disease control and longer PFS with RT. ❌ But NO OS benefit demonstrated! An important reminder: improving PFS does not necessarily translate into longer survival. Thought-provoking data challenging the routine use of consolidative RT in this setting! #ESMOAmbassadors #ESMO26 #LungCancer #NSCLC
🆙 #ESMO26 Proffered Paper I: #LCSM Mets 🔥SARON: Primary Results of a Randomised-Controlled Trial of Consolidation Radiotherapy for Synchronous Oligometastatic Non-Small Cell Lung Cancer 🎙️Dr. Fiona McDonald @fifimcdrmh 🔢2613O 🎯SACT+RT Improved PFS (13.9 vs 8.9m, HR 0.64, p=0.03) and 12-Mo Local Failure (13.0% vs 39.5%) 🎯No OS Benefit (31.0 vs 28.0mo, HR 0.99) ☑️NCT02417662 🔗 https://t.co/uGHKJfjhvW @OncoAlert @Larvol @myESMO @IASLC
@fifimcdrmh presenting SARON trial. Consolidation RT. Primary endpoint OS. Initially meant to accrue 306 pts but changed to 140. 45% had chemo/IO. No diff in OS. Does change to PhII alter interpretation or is this the end of RT consolidation? Aes similar #LCSM #ESMO26 https://t.co/hCfJngIHEB
SARON; 1-5 mets; 6-8w induction SACT; P2 study:n140; 10y recruitment; SACT used evolved to include IO but valences in arms; no difference in OS; PFS 0.64HR but no difference new sites of disease #ESMO26 @BTOGORG #LCSM Great presentation @fifimcdrmh https://t.co/y6hzhSquQG
🇬🇧 UK-led SARON trial at #ESMO2026: 140 patients across 22 centres. Adding RT to systemic therapy in oligometastatic NSCLC improved PFS (13.9 vs 8.9 months) and local control, but not OS (HR 0.99). Important UK academic research informing clinical practice. #LungCancer #ESMO26 https://t.co/DALqlBAhmB
#ESMO26 Dr. @fifimcdrmh presents the SARON trial. Phase II of consolidation radiotherapy vs systemic therapy in pts with driver negative oligometastatic NSCLC after 6-8w of control with systemic therapy. Improvement in PFS with radiation 13.9 vs 8.9m but no difference in OS. https://t.co/hrnVmeH53X
#ESMO26 | SARON RT improves local control and delays progression, but no survival benefit was demonstrated. There was no significant reduction in new distant metastases either. https://t.co/PaP1tQXPlX
Presenting the UK’s SARON study Dr @fifimcdrmh to a full hall at #ESMO26 In patients with de novo oligometastatic mutation driver negative #NSCLC , consolidation radiotherapy to the primary and metastases improved PFS but no OS No significant difference in QOL or AEs Huge thanks to all the patients and trialists involved
On a beautiful sunny #Madrid we go to present the results of the SARON study at #ESMO26 Over a decade of work being presented in 10 minutes https://t.co/XjT5y4wJya
Phase II SARON (n=140,NSCLC): Consolidation RT + 1L SACT improved: • PFS: 13.9 vs 8.9 mo (p=0.03) • 12-mo local failure: 13% vs 39.5% (p<0.01) No OS benefit (31 vs 28 mo; p=0.95). Grade ≥3 toxicity: 28.6% both arms. #ESMO26 @Larvol @OncodailyLung https://t.co/99mkC2CR2j
🫁 Better local control does not always mean longer survival. @OncoAlert At #ESMO26, the randomized phase II SARON trial tested whether adding consolidation radiotherapy to first-line systemic therapy could improve outcomes in synchronous oligometastatic, AGA-negative #NSCLC. 📊 n=140 ➡️ Median PFS: 13.9 vs 8.9 months HR 0.64, p=0.03 ➡️ 12-month local failure: 13.0% vs 39.5% p<0.01 ➡️ Median OS: 31.0 vs 28.0 months HR 0.99, p=0.95 ⚠️ Grade ≥3 AEs: 28.6% in both arms 🎯 Why this matters: consolidation RT clearly improved disease control and reduced local failure, but that did not translate into an OS benefit. For me, this is a reminder that oligometastatic disease is not a single biological state. The value of local therapy may depend on patient selection, disease biology, timing, and whether control of visible disease can meaningfully alter the systemic course. Excellent work presented by @fifimcdrmh. Pinging @christine_lovly @GlopesMd @DrSanjayPopat @StephenVLiu @jillfeldman4 @UOzkerim @DrMirallas @MartinReck2 @CharuAggarwalMD @peters_solange #OncoAlert #ESMO26 #LungCancer #OligometastaticDisease #Radiotherapy #PrecisionOncology
🆙 #ESMO26 Proffered Paper I: #LCSM Mets 🔥SARON: Primary Results of a Randomised-Controlled Trial of Consolidation Radiotherapy for Synchronous Oligometastatic Non-Small Cell Lung Cancer 🎙️Dr. Fiona McDonald 🔢2613O 🎯SACT+RT Improved PFS (13.9 vs 8.9m, HR 0.64, p=0.03) and 12-Mo Local Failure (13.0% vs 39.5%) 🎯No OS Benefit (31.0 vs 28.0mo, HR 0.99) ☑️NCT02417662 🔗 https://t.co/uGHKJfiJGo @OncoAlert @Larvol @myESMO @IASLC
Posted on October 21, when the 2613O abstract was released.
A smorgasbord of #RadOnc excellence at #AILCC26 featuring insights from: - @gwalls89 SABR growth in NI, & new technology @BelfastTrust - @rmcd22 on the superb @uniofgalway lung MDT - @fifimcdrmh on RT in oligomet dx, SARON results due out @myESMO @IrishLungCancer #LCSM https://t.co/iyFep8s2YL
Posted before the presentation on October 25.
Countdown to #ESMO26 🔺SARON 🔺RT in synchronous oligometastatic NSCLC 🔺@fifimcdrmh ✅ Proper, randomised, controlled trial of RT in oligometastatic NSCLC ⚠️ We have various older, non-randomised or retrospective data which help, but which does answer all the important questions 🇬🇧 Mammoth effort to get this big study completed 🫵 Be there: the results will impact on your practice #LCSM
Posted before the presentation on October 25.
These 2 presentations at #ESMO26 could very well be practice changing or affirming. Have been avidly anticipating both. Some fundamental questions in the management of advanced NSCLC will be answered @BTOGORG https://t.co/vpumhpHwTx
Posted before the presentation on October 25.
SARON Trial Design
SARON asked whether adding consolidation radiotherapy to every site of disease improves survival for patients with synchronous oligometastatic NSCLC without actionable genomic alterations who are receiving first-line chemotherapy and/or immunotherapy. The trial is sponsored by University College London, funded by Cancer Research UK and coordinated by the UCL Cancer Trials Centre. Results were presented by the chief investigator, Fiona McDonald, MD (The Royal Marsden and The Institute of Cancer Research, London), at ESMO 2026 (2613O, Proffered paper 1: NSCLC, metastatic, October 25, 2026), with Benjamin Levy, MD, as invited discussant for SARON and PERSEE.
Study Design
Multicenter, randomized (1:1), open-label phase II in the UK (NCT02417662; UCL/13/0594). 140 patients randomized (70 per arm), October 2016 to July 2023. Randomization by minimization, stratified by SACT, histology, N stage, number of metastases, brain metastases and recruiting site. The design schema prints N=200 at registration and N=134 at randomization; 140 were randomized.
Population
NSCLC without actionable genomic alteration; primary tumor (± nodes) suitable for radical RT or SABR; 1–5 synchronous metastases in up to 3 organs treatable by SABR/SRS; PS 0–1; PET-CT and brain CT/MRI staged; no progression after 6–8 weeks of induction SACT. Median age 68; 59.3% male; 58.6% adenocarcinoma; 52.9% N2/N3; 62.9% one metastasis; 6.4% brain metastases.
Interventions
Both arms: up to a further 4–6 weeks of induction SACT, then maintenance as indicated. Investigational arm: radical conventional RT or SABR to the primary tumor (± locoregional nodes) plus SABR/SRS to all metastases. Control arm: SACT alone. Per the abstract, the control (SACT) regimen changed to include immunotherapy in January 2020; immunotherapy-containing SACT was used in 58.6% (control) and 61.4% (investigational) of patients (treatment slide).
Endpoints
Primary: overall survival. Major secondary: progression-free survival. Other secondary endpoints (ClinicalTrials.gov): toxicity, local tumor control, new distant metastasis-free survival, OS from start of induction SACT, quality of life (EORTC QLQ-C30, LC13).
Presenter & Discussant
Presenter and chief investigator: Fiona McDonald, MD (Royal Marsden, London). Invited discussant: Benjamin Levy, MD.
Data Cut
Primary results; median follow-up 37.4 months. A data-cutoff date was not printed in the abstract or on the slides reviewed.
SARON in the News
SARON Questions
What is the SARON trial?
SARON (NCT02417662) is a UK multicenter, randomized phase II trial sponsored by University College London and funded by Cancer Research UK. After 6–8 weeks of first-line systemic anti-cancer therapy (SACT), 140 patients with synchronous oligometastatic NSCLC (1–5 metastases in up to 3 organs) and no actionable genomic alteration were randomized 1:1 to continue SACT alone or to add consolidation radiotherapy: radical conventional RT or SABR to the primary tumor and SABR or stereotactic radiosurgery to every metastasis.
What did SARON show at ESMO 2026?
The primary endpoint, overall survival, was not improved: median OS was 31.0 vs 28.0 months, HR 0.99 (95% CI 0.63–1.55), P = 0.95. Progression-free survival, the major secondary endpoint, was longer with radiotherapy: 13.9 vs 8.9 months, HR 0.64 (95% CI 0.43–0.95), P = 0.03. Figures are from abstract 2613O and the presentation, after a median follow-up of 37.4 months. See At a Glance.
Did radiotherapy reduce new metastases?
No. At 12 months, progression at sites of initial disease was 13.0% vs 39.5% (P < 0.01, abstract), but progression at new sites was 36.2% with radiotherapy vs 32.3% without (P = 0.28).
Was consolidation radiotherapy safe?
The abstract reports a grade ≥3 adverse event rate of 28.6% in both arms, with 6 patients having a grade 3 event possibly related to radiotherapy. EORTC QLQ-C30 and LC13 quality-of-life scores were similar in both arms.
Is consolidation radiotherapy for oligometastatic NSCLC a new standard after SARON?
SARON tested a radiotherapy strategy, not a drug, so there is no regulatory approval involved. The trial did not show an overall survival benefit, which was its primary endpoint. Physicians disagreed on what that means for practice; their posts are in Discussion Threads and Physician Reactions. The invited discussant, Benjamin Levy, MD, said he would no longer routinely refer patients for consolidative RT/SABR solely because they meet oligometastatic criteria.
How much of the radiotherapy was SABR?
Of 70 patients randomized to radiotherapy, 62 (88.6%) received radical radiotherapy to the primary tumor: 51 with conventional radiotherapy and 11 with SABR. 54 (77.1%) received SABR to at least one metastatic site, and 8 received no radiotherapy.