Combined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates

Abstract The efficacy of immunotherapy for advanced non‐small cell lung cancer (NSCLC) remains unsatisfactory, as the majority of patients either do not experience an objective response or acquire secondary resistance. As a result, several methods to enhance the systemic efficacy of immunotherapy ha...

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Autores principales:	Shijie Shang, Jie Liu, Vivek Verma, Meng Wu, James Welsh, Jinming Yu, Dawei Chen
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	immune checkpoint inhibitors immunotherapy immunotherapy combined with radiotherapy low‐dose radiotherapy non‐small cell lung cancer radiotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/1574272ad6444804a89cd9d61272afb1
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spelling	oai:doaj.org-article:1574272ad6444804a89cd9d61272afb12021-11-27T06:05:32ZCombined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates2523-354810.1002/cac2.12226https://doaj.org/article/1574272ad6444804a89cd9d61272afb12021-11-01T00:00:00Zhttps://doi.org/10.1002/cac2.12226https://doaj.org/toc/2523-3548Abstract The efficacy of immunotherapy for advanced non‐small cell lung cancer (NSCLC) remains unsatisfactory, as the majority of patients either do not experience an objective response or acquire secondary resistance. As a result, several methods to enhance the systemic efficacy of immunotherapy have been investigated, including a large area of active research by combining immunotherapy with radiation therapy (RT). Given the rapidly burgeoning concept of combining immunotherapy and RT for increasing therapeutic benefit, we review the progress in this field thus far and explore further avenues for enhancing this combination. This review commences with a discussion of the only two existing randomized trials (and a pooled analysis) showing that the addition of RT to immunotherapy improves the abscopal response rate, progression‐free survival, and overall survival in metastatic NSCLC patients. We then discussed factors and biomarkers that may be associated with a proportionally greater benefit to additional RT, such as low programmed cell death protein ligand 1 (PD‐L1) status, tumor mutational burden (TMB), and patient's immune function. Next, the implementation of RT to overcome immunotherapy resistance is discussed, including a mechanistic discussion and methods with which these mechanisms could be exploited. Lastly, the emerging role of low‐dose RT is discussed, which may help to overcome inhibitory signals in the tumor stroma that limit T‐cell infiltration. Taken together, given the current state of this rapidly expanding realm, these futuristic strategies may be reflected upon to further enhance the efficacy of immunotherapy for a wider group of patients.Shijie ShangJie LiuVivek VermaMeng WuJames WelshJinming YuDawei ChenWileyarticleimmune checkpoint inhibitorsimmunotherapyimmunotherapy combined with radiotherapylow‐dose radiotherapynon‐small cell lung cancerradiotherapyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Communications, Vol 41, Iss 11, Pp 1086-1099 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	immune checkpoint inhibitors immunotherapy immunotherapy combined with radiotherapy low‐dose radiotherapy non‐small cell lung cancer radiotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	immune checkpoint inhibitors immunotherapy immunotherapy combined with radiotherapy low‐dose radiotherapy non‐small cell lung cancer radiotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Shijie Shang Jie Liu Vivek Verma Meng Wu James Welsh Jinming Yu Dawei Chen Combined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates
description	Abstract The efficacy of immunotherapy for advanced non‐small cell lung cancer (NSCLC) remains unsatisfactory, as the majority of patients either do not experience an objective response or acquire secondary resistance. As a result, several methods to enhance the systemic efficacy of immunotherapy have been investigated, including a large area of active research by combining immunotherapy with radiation therapy (RT). Given the rapidly burgeoning concept of combining immunotherapy and RT for increasing therapeutic benefit, we review the progress in this field thus far and explore further avenues for enhancing this combination. This review commences with a discussion of the only two existing randomized trials (and a pooled analysis) showing that the addition of RT to immunotherapy improves the abscopal response rate, progression‐free survival, and overall survival in metastatic NSCLC patients. We then discussed factors and biomarkers that may be associated with a proportionally greater benefit to additional RT, such as low programmed cell death protein ligand 1 (PD‐L1) status, tumor mutational burden (TMB), and patient's immune function. Next, the implementation of RT to overcome immunotherapy resistance is discussed, including a mechanistic discussion and methods with which these mechanisms could be exploited. Lastly, the emerging role of low‐dose RT is discussed, which may help to overcome inhibitory signals in the tumor stroma that limit T‐cell infiltration. Taken together, given the current state of this rapidly expanding realm, these futuristic strategies may be reflected upon to further enhance the efficacy of immunotherapy for a wider group of patients.
format	article
author	Shijie Shang Jie Liu Vivek Verma Meng Wu James Welsh Jinming Yu Dawei Chen
author_facet	Shijie Shang Jie Liu Vivek Verma Meng Wu James Welsh Jinming Yu Dawei Chen
author_sort	Shijie Shang
title	Combined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates
title_short	Combined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates
title_full	Combined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates
title_fullStr	Combined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates
title_full_unstemmed	Combined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates
title_sort	combined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/1574272ad6444804a89cd9d61272afb1
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Combined treatment of non‐small cell lung cancer using radiotherapy and immunotherapy: challenges and updates

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