Lung Stereotactic Body Radiation Therapy and Concurrent Immunotherapy: A Multicenter Safety and Toxicity Analysis

Tian, Sibo; Switchenko, Jeffrey M.; Buchwald, Zachary S.; Patel, Pretesh; Shelton, Joseph; Kahn, Shannon; Pillai, Rathi N.; Steuer, Conor E.; Owonikoko, Taofeek K.; Behera, Madhusmita; Higgins, Kristin

doi:10.1016/j.ijrobp.2019.12.030

Cited by 49 publications

(31 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A multicenter safety and toxicity analysis showed that the associated subacute grade ≥ 3 irAEs in patients with SBRT in combination with ICIs or SBRT monotherapy were 26.8% and 2.9%, respectively. The risks of any grade pneumonitis were similar in the two groups (33.9% vs 27.9%, p = 0.47), with a significant difference in grade ≥ 3 pneumonitis (10.7% vs 0%, p < 0.01) [105]. A phase 1 study with multisite SBRT and pembrolizumab treatment as well as the PEMBRO-RT phase 2 randomized trial showed concordant results with tolerable irAEs [39,67].…”

Section: Safetymentioning

confidence: 77%

SBRT combined with PD-1/PD-L1 inhibitors in NSCLC treatment: a focus on the mechanisms, advances, and future challenges

et al. 2020

View full text Add to dashboard Cite

Immune checkpoint inhibitors targeting programmed cell death 1 (PD-1), programmed cell death ligand-1 (PD-L1), and others have shown potent clinical efficacy and have revolutionized the treatment protocols of a broad spectrum of tumor types, especially non-small-cell lung cancer (NSCLC). Despite the substantial optimism of treatment with PD-1/PD-L1 inhibitors, there is still a large proportion of patients with advanced NSCLC who are resistant to the inhibitors. Preclinical and clinical trials have demonstrated that radiotherapy can induce a systemic antitumor immune response and have a great potential to sensitize refractory "cold" tumors to immunotherapy. Stereotactic body radiation therapy (SBRT), as a novel radiotherapy modality that delivers higher doses to smaller target lesions, has shown favorable antitumor effects with significantly improved local and distant control as well as better survival benefits in various solid tumors. Notably, research has revealed that SBRT is superior to conventional radiotherapy, possibly because of its more powerful immune activation effects. Thus, PD-1/PD-L1 inhibitors combined with SBRT instead of conventional radiotherapy might be more promising to fight against NSCLC, further achieving more favorable survival outcomes. In this review, we focus on the underlying mechanisms and recent advances of SBRT combined with PD-1/PD-L1 inhibitors with an emphasis on some future challenges and directions that warrant further investigation.

show abstract

Section: Safetymentioning

confidence: 77%

SBRT combined with PD-1/PD-L1 inhibitors in NSCLC treatment: a focus on the mechanisms, advances, and future challenges

et al. 2020

View full text Add to dashboard Cite

show abstract

“…With the clinical implementation of immunotherapeutic protocols, the impact of immune checkpoint inhibition (ICI) on the development of RIP needs to be examined and is currently under investigation [143,144]. Programmed cell death 1 (PD-1)/ Programmed cell death 1 ligand 1 (PD-L1) inhibition alone can cause immune-mediated pneumonitis in less than 5% [145]. Furthermore, radiation recalls several months after thoracic radiotherapy while ICI is still being administered have been described in some cases [144,146].…”

Section: Treatment-related Risk Factors Of Ripmentioning

confidence: 99%

Radiation-induced lung toxicity – cellular and molecular mechanisms of pathogenesis, management, and literature review

et al. 2020

View full text Add to dashboard Cite

Lung, breast, and esophageal cancer represent three common malignancies with high incidence and mortality worldwide. The management of these tumors critically relies on radiotherapy as a major part of multi-modality care, and treatment-related toxicities, such as radiation-induced pneumonitis and/or lung fibrosis, are important dose limiting factors with direct impact on patient outcomes and quality of life. In this review, we summarize the current understanding of radiation-induced pneumonitis and pulmonary fibrosis, present predictive factors as well as recent diagnostic and therapeutic advances. Novel candidates for molecularly targeted approaches to prevent and/or treat radiation-induced pneumonitis and pulmonary fibrosis are discussed.

show abstract

“…Although data are lacking with concurrent ICI use for cardiac SBRT, a report by Gabani et al treated a primary cardiac angiosarcoma with concurrent paclitaxel and SBRT to 30 Gy in five fractions and did only note mild esophagitis acutely [21] . However, other data combining ICI with lung SBRT have noted increased rates of pneumonitis [23] , requiring diligence with dose constraints.…”

Section: Discussionmentioning

confidence: 99%

MR-guided stereotactic body radiation therapy for intracardiac and pericardial metastases

Sim

Palm

Delozier

et al. 2020

Clinical and Translational Radiation Oncology

View full text Add to dashboard Cite

show abstract

Lung Stereotactic Body Radiation Therapy and Concurrent Immunotherapy: A Multicenter Safety and Toxicity Analysis

Cited by 49 publications

References 34 publications

SBRT combined with PD-1/PD-L1 inhibitors in NSCLC treatment: a focus on the mechanisms, advances, and future challenges

SBRT combined with PD-1/PD-L1 inhibitors in NSCLC treatment: a focus on the mechanisms, advances, and future challenges

Radiation-induced lung toxicity – cellular and molecular mechanisms of pathogenesis, management, and literature review

MR-guided stereotactic body radiation therapy for intracardiac and pericardial metastases

Contact Info

Product

Resources

About