Low-dose radiotherapy as a chemo-potentiator of a chemotherapy regimen with pemetrexed for recurrent non-small-cell lung cancer: A prospective phase II study

Determining if low dose hyper-radiosensitivity (HRS) can be exploited to provide a therapeutic advantage: A cell line study in four glioblastoma multiforme (GBM) cell lines

“…Indeed, the combination of a taxane, to induce cell synchronization and enhance the proportion of G2-phase cells, in combination with low dose radiation was shown to improve tumor curability in a preclinical model (Dey et al 2003, Spring et al 2004). Similar chemopotentiation approaches in human clinical series have also demonstrated the benefit of combined low dose radiation and chemotherapeutic agents, albeit with small numbers of patients (Valentini et al 2010, Mantini et al 2012. Similar cell synchronization approaches may have to be employed to demonstrate the full effect of ultrafractionation for cells in tissue culture.…”

The predictive value of 18F-FDG PET-CT for assessing the clinical outcomes in locally advanced NSCLC patients after a new induction treatment: low-dose fractionated radiotherapy with concurrent chemotherapy

“…In the last years, low-dose fractionated radiotherapy (<1 Gy) concurrent to the induction chemotherapy has been proposed to further improve the effects of induction chemotherapy in several solid tumours, such as locally advanced breast cancer [37, 38], pancreatic cancer [39], head neck carcinoma [40], glioblastoma [41] and NSCLC [42]. In-vitro studies have demonstrated that LDRT chemo-potentiates the effects of cisplatin [42], and that concomitant four low-dose radiotherapy fractions provide the optimal cell killing, either with apoptosis or clonogenic inhibition [43, 44], without further increasing toxicity.…”

“…In-vitro studies have demonstrated that LDRT chemo-potentiates the effects of cisplatin [42], and that concomitant four low-dose radiotherapy fractions provide the optimal cell killing, either with apoptosis or clonogenic inhibition [43, 44], without further increasing toxicity. Moreover, in-vivo studies on several types of epithelial cancer have demonstrated that LDRT is feasible and well tolerated [42], having an overall response rate of 45% [42, 45]. In our study, after two cycles of IC-LDRT, we observed a significant reduction of the metabolic activity, as expressed by the SUL peak reduction, indicating that also this approach acts on all tumour cells both in primary tumours and lymph-nodes.…”

“…In addition, after IC-LDRT, approximately 50% of patients showed good results, such as complete and/or partial metabolic response and, therefore, defined as responders. This finding allows to state that also this induction approach, considered preparatory for the stronger subsequent therapies, acts on tumour cells killing or stunning them [42, 43] as demonstrated by the reduction of metabolic activity. These favourable results allowed modifying, although in few patients, the planned therapeutic scheme leading them directly to surgery.…”

Primary systemic treatment and concomitant low dose radiotherapy for breast cancer: Final results of a prospective phase II study

“…Concurrent palliative chemotherapy and LD-FRT have been evaluated in patients with various type of epithelial tumors; the overall response rate was 45% with low toxicity [26]. A prospective phase II study demonstrated that LD-FRT combined with pemetrexed in patients affected by recurrent non small cell lung cancer is a feasible and well tolerated novel approach, with a response rate of 42% [27]. A phase I study reported that concomitant LD-FRT and chemotherapy with non-pegylated liposomal anthracycline and docetaxel is a feasible preoperative approach in treatment of IIA-B/IIIA stage breast cancer.…”