Stereotactic Ablative Radiotherapy Combined with Immune Checkpoint Inhibitors Reboots the Immune Response Assisted by Immunotherapy in Metastatic Lung Cancer: A Systematic Review

International Journal of Molecular Sciences

PedroC Lara¹  Ignacio Morales-Orue²  Juan Castilla-Martinez²  Andrea Kannemann²  Juan Zafra-Martin²  Rodolfo Chicas-Sett²  Jesus Blanco²  Marta Lloret² 

[1] Department of Oncology, San Roque University Hospital, Calle Dolores de la Rocha 5, 35001 Las Palmas de Gran Canaria, Spain;Department of Radiation Oncology, “Dr. Negrín” University Hospital of Gran Canaria, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain;

关键词: abscopal effect;    radiotherapy;    immunotherapy;    CTLA-4;    Anti-PD-1/PD-L1;    SABR;    ICI;    SBRT;   

DOI  :  10.3390/ijms20092173

来源: DOAJ

【 摘 要 】

Background: Immune checkpoint inhibitors (ICI) have represented a revolution in the treatment of non-small-cell lung cancer (NSCLC). To improve these results, combined approaches are being tested. The addition of stereotactic ablative radiotherapy (SABR) to ICI seems promising. A systematic review was performed in order to assess the safety and efficacy of SABR-ICI combination. Material and Methods: MEDLINE databases from 2009 to March 3, 2019 were reviewed to obtain English language studies reporting clinical outcomes of the combination of ICI-SABR in NSCLC. 18 out of the 429 initial results fulfilled the inclusion criteria and were selected for review. Results: Eighteen articles, including six prospective studies, describing 1736 patients treated with an ICI-SABR combination fulfilled the selection criteria. The reported mean rates for local control and distant/abscopal response rates were 71% and 41%, respectively. Eleven studies reported progression-free survival and overall survival, with a mean of 4.6 and 12.4 months, respectively. Toxicity rates were consistent with the ones attributable to ICI treatment alone. Conclusions: The ICI-SABR combination has a good safety profile and achieves high rates of local control and greater chances of obtaining abscopal responses than SABR alone, with a relevant impact on PFS. More studies are needed to improve patient selection for an optimal benefit from this approach.

【 授权许可】

Unknown