Systemic Immunostimulatory Effects of Radiation Therapy Improves the Outcomes of Patients With Advanced NSCLC Receiving Immunotherapy

This article provides an overview of the current state of knowledge of the clinical experience using radiation therapy in combination with immune therapy and discusses the rationale for integrating these 2 modalities in the treatment of advanced non–small cell lung cancer. Available data supports the use of radiation therapy in combination with immunotherapy to achieve improved local and systemic tumor control. Evidence from the early clinical trials has shown that using radiation therapy and immune checkpoint blockade therapies together produces a greater clinical effect than using either modality alone. To maximize the clinical benefit and successful integration of these two modalities as well as optimizing radiation therapy dosing and its schedule, improvement in its field design and the development of reliable predictors of clinical tumor response needs to be established.
Source: American Journal of Clinical Oncology - Category: Cancer & Oncology Tags: Review Article Source Type: research

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te;rrez L, Martínez López E Abstract The constant advances in the field of lung cancer immunotherapy have recently reached the treatment of locally advanced disease with the approval of durvalumab after concurrent chemoradiation. However, radiation therapy continues to be key for controlling the disease at this stage. Over the years, different strategies have been employed to try to optimize outcomes using radiotherapy, with cardiac and pulmonary toxicity as the main limitation on its success. The interest in the use of hypofractionation and stereotactic body radiation therapy for stage III non-small...
Source: Anales del Sistema Sanitario de Navarra - Category: General Medicine Authors: Tags: An Sist Sanit Navar Source Type: research
Immune checkpoint inhibitors have recently been demonstrated to improve survival in metastatic and locally advanced non-small cell lung cancer (NSCLC). Radiation therapy has a well-established role in the treatment of NSCLC and has more recently been shown to be immunostimulatory, with the potential to enhance the efficacy of immunotherapy. This comprehensive review details the current roles of radiation therapy and immune checkpoint inhibitors in NSCLC, discusses the intersection of these two modalities and their potential to have combined synergistic responses, and highlights existing preclinical and clinical data and on...
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Conclusion: In patients presenting with oligometastatic lung cancer limited to the brain, treatment with both lung SBRT and brain SRS achieves good LC of all sites with encouraging OS. PMID: 31956701 [PubMed]
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Tags: Clin Transl Radiat Oncol Source Type: research
Objective: Anti-PD-1 antibodies can cause drug-induced pneumonitis. We aimed to identify the clinical and radiologic characteristics, the incidence, risk factors, and appropriate management of pneumonitis related to anti-PD-1 immunotherapy in patients with non-small cell lung cancer (NSCLC).Materials and Methods: Medical records and chest computed tomography scans of patients with NSCLC treated with anti-PD-1 antibodies between January 2016 and June 2018 at the Kanagawa Cancer Center were retrospectively analyzed. Clinical characteristics of patients treated with anti-PD-1 antibodies who developed pneumonitis were compared...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung cancer Source Type: research
We present a prospective study of hypofractionated, image-guided radiation therapy (HIGRT) to a single site of metastatic disease concurrently with atezolizumab in patients with metastatic NSCLC.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Source Type: research
Conditions:   Metastatic Lung Non-Small Cell Carcinoma;   Recurrent Lung Non-Small Cell Carcinoma;   Stage IV Lung Cancer AJCC v8;   Stage IVA Lung Cancer AJCC v8;   Stage IVB Lung Cancer AJCC v8 Interventions:   Procedure: Positron Emission Tomography;   Procedure: Computed Tomography;   Drug: Chemotherapy;   Biological: Immunotherapy;   Radiation: Radiation Therapy Sponsors:   University of Washingto...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Nature Reviews Clinical Oncology, Published online: 20 September 2019; doi:10.1038/s41571-019-0277-2In the past few years, efforts have been made to combine two approaches — immune-checkpoint inhibition and locally ablative radiation therapy — to treat patients with metastatic non-small-cell lung cancer. Herein we discuss the implications of two studies that support the existence of a systemic therapy augmented by radiotherapy (STAR) effect in this setting.
Source: Nature Reviews Clinical Oncology - Category: Cancer & Oncology Authors: Source Type: research
Authors: Niranjan A, Lunsford LD, Ahluwalia MS Abstract The most common primary cancers that metastasize to the brain are lung cancer, breast cancer, and melanoma. The established management approaches for brain metastasis include stereotactic radiosurgery, fractionated radiation therapy, and surgical resection. In the past the role of medical therapies in brain metastases was limited. In the last decade, our understanding of molecular drivers of brain metastases and CNS penetration of drugs across the blood-brain barrier has improved. The molecular targeted tyrosine kinase inhibitors have shown effectiveness in br...
Source: Progress in Neurological Surgery - Category: Neurosurgery Tags: Prog Neurol Surg Source Type: research
Immune checkpoint inhibition (ICI) targeting the programmed death receptor 1 (PD-1) has shown promising results in the fight against cancer. Systemic anti-tumor reactions due to radiation therapy (RT) can lead to regression of non-irradiated lesions (NiLs), termed "abscopal effect" (AbE). Combination of both treatments can enhance this effect. The aim of this study was to evaluate AbEs during anti-PD-1 therapy and irradiation. We screened 168 patients receiving pembrolizumab or nivolumab at our center. Inclusion criteria were start of RT within 1 month after the first or last application of pembrolizumab (2mg/kg...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
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