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Radiotherapy and Immunotherapy Combinations for Lung Cancer

  • Lung Cancer (H Borghaei, Section Editor)
  • Published:
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Abstract

Purpose of Review

Positive results from recent immunotherapy trials of non-small cell lung cancer (NSCLC) have coincided with a greater appreciation for the impact of radiation therapy (RT) on tumor immunity. Here, we summarize key clinical findings and ongoing efforts to combine immunotherapy and RT for the treatment of NSCLC.

Recent Findings

The role of immunotherapy for NSCLC has expanded significantly following the pivotal approvals of nivolumab and pembrolizumab for metastatic NSCLC, maintenance durvalumab in unresectable stage III NSCLC, and atezolizumab for metastatic NSCLC. Several small early-phase trials have demonstrated the ability of RT to elicit clinically significant tumor immunity. These positive findings support current trial efforts combining RT with immunotherapy for NSCLC.

Summary

Recently initiated trials of RT and immunotherapy hold significant promise in expanding the therapeutic options for NSCLC. Optimization of therapy will require careful patient selection to yield meaningful improvements in clinical outcomes.

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Abbreviations

BED:

Biologically effective dose

CPR:

Complete pathologic response

CTLA-4:

Cytotoxic T lymphocyte antigen-4

MPR:

Major pathologic response

NSCLC:

Non-small cell lung carcinoma

ORR:

Overall response rate

OS:

Overall survival

PD-1:

Programmed cell death protein 1

PD-L1:

Programmed cell death ligand 1

PFS:

Progression-free survival

RT:

Radiation therapy

SABR:

Stereotactic ablative body radiotherapy

SBRT:

Stereotactic body radiation therapy

TMB:

Tumor mutational burden

TPS:

Tumor proportion score

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Authors and Affiliations

  1. Department of Radiation Oncology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY, USA

    Vishesh Agrawal & Eric C. Ko

  2. Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Kimberly Thomas Benjamin

  3. Department of Radiation Oncology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA

    Eric C. Ko

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  1. Vishesh Agrawal
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Agrawal, V., Benjamin, K.T. & Ko, E.C. Radiotherapy and Immunotherapy Combinations for Lung Cancer. Curr Oncol Rep 23, 4 (2021). https://doi.org/10.1007/s11912-020-00993-w

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