Lung Cancer Study Tests Direct Tumor Injections

Patients with stage 3 non-small cell lung cancer that cannot be removed surgically may now be eligible for a new treatment approach. Researchers are testing whether injecting a radiation-enhancing medicine directly into a tumor can improve how well tumors respond to chemoradiation followed by immunotherapy. The trial, known as CONVERGE, is evaluating an investigational drug called JNJ-1900, or NBTXR3, which consists of hafnium oxide nanoparticles.

Targeting the tumor directly

This method, called intratumoral therapy, delivers treatment straight into the cancer rather than through an intravenous line or a pill. Dr. David DiBardino, an interventional pulmonologist at the University of Pennsylvania, explained that the goal is to target the largest tumors with concentrated radiation, avoiding the safety concerns that come from increasing radiation to the entire treatment field.

The procedure adds a single step before standard care begins. Doctors use a bronchoscope with a camera to guide a needle into the lung or lymph nodes. The patient is typically under general anesthesia. One to two days after the injection, a CT scan confirms where the medication landed, allowing the radiation oncologist to adjust the treatment plan if needed. This extra scan acts as a safety measure built into the protocol.

The CONVERGE trial follows a standard regimen: patients receive chemotherapy and radiation at the same time, followed by the immunotherapy drug Imfinzi (durvalumab) given by IV. Early results from the first part of the trial involved seven patients who completed the full treatment plan. Six of the seven patients saw their tumors shrink, and four had a complete response with no visible cancer on scans. The cancer did not grow in any of the seven patients.

Standard treatment for this form of lung cancer rarely results in a complete response, occurring in fewer than 5% of patients. Because these results come from a small group, they are considered preliminary and may not predict the outcome of the larger study.

Reaching lung tumors has historically been difficult for specialists. The lungs move with every breath, and a tumor can shift position between scans and during a procedure. Advancements in technology have helped overcome these challenges. Smaller cameras can now travel deeper into the lungs, and robotic-assisted bronchoscopy provides guidance similar to a GPS. For lymph nodes, doctors can use ultrasound or miniature CT scans during the procedure to confirm they have reached the intended location.

Because the lungs are not like sponges, the dose is not based on a patient’s body weight but on the size of the tumor. One group receives slightly more than one-fifth of the tumor’s volume, while another receives about one-third. The goal is to deliver enough drug into the tumor without overwhelming it.

Trials continue across sites

The trial is an international effort taking place at more than 30 locations. To ensure consistency and safety, doctors must use imaging to confirm the needle is inside the tumor before each injection. More than 60 of the 120 planned patients have enrolled in CONVERGE so far.

Findings on how the procedure was performed were later presented at the American Association for Bronchology and Interventional Pulmonology Annual Meeting. That meeting was held in Denver from August 20 to 22. The researchers concluded that injecting the medicine into lung tumors and lymph nodes appears feasible. It can also be done safely, though the small number of patients means results are preliminary.

CONVERGE Trial Presentation Details

Researchers submitted the trial details to ClinicalTrials.gov on August 28, 2026. The data were shared during the 2026 European Society for Radiotherapy and Oncology Annual Meeting in May.

A model for future treatments

DiBardino said CONVERGE could also provide a model for studying other medicines, proteins, and vaccines delivered directly into lung tumors. He described the approach as a “boost” alongside existing treatments. The drug works by being switched on by radiation. This method targets the largest tumors with concentrated radiation. It avoids safety concerns that come from increasing radiation to the entire treatment field.