Stereotactic Ablative Radiotherapy Combined with Immune Checkpoint Inhibitors Reboots the Immune Response Assisted by Immunotherapy in Metastatic Lung Cancer: A Systematic Review
Open Access
- 2 May 2019
- journal article
- review article
- Published by MDPI AG in International Journal of Molecular Sciences
- Vol. 20 (9), 2173
- https://doi.org/10.3390/ijms20092173
Abstract
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.Keywords
This publication has 65 references indexed in Scilit:
- Tumor-Induced CD8+ T-Cell Dysfunction in Lung Cancer PatientsClinical and Developmental Immunology, 2012
- Prognostic Impact of Radiation Therapy to the Primary Tumor in Patients With Non-small Cell Lung Cancer and Oligometastasis at DiagnosisInternational Journal of Radiation Oncology*Biology*Physics, 2012
- Stereotactic ablative radiotherapy for comprehensive treatment of oligometastatic tumors (SABR-COMET): Study protocol for a randomized phase II trialBMC Cancer, 2012
- Safety, Activity, and Immune Correlates of Anti–PD-1 Antibody in CancerThe New England Journal of Medicine, 2012
- Ipilimumab in Combination With Paclitaxel and Carboplatin As First-Line Treatment in Stage IIIB/IV Non–Small-Cell Lung Cancer: Results From a Randomized, Double-Blind, Multicenter Phase II StudyJournal of Clinical Oncology, 2012
- Hypofractionated Image-Guided Radiation Therapy for Patients with Limited Volume Metastatic Non-small Cell Lung CancerJournal of Thoracic Oncology, 2012
- Stereotactic Body Radiation Therapy for Inoperable Early Stage Lung CancerJama-Journal Of The American Medical Association, 2010
- Stereotactic Body Radiation Therapy for Early-Stage Non–Small-Cell Lung Carcinoma: Four-Year Results of a Prospective Phase II StudyInternational Journal of Radiation Oncology*Biology*Physics, 2009
- Outcome in a Prospective Phase II Trial of Medically Inoperable Stage I Non–Small-Cell Lung Cancer Patients Treated With Stereotactic Body RadiotherapyJournal of Clinical Oncology, 2009
- Whole Body Irradiation—Radiobiology or Medicine?The British Journal of Radiology, 1953