Article Details


The Combination of New Immunotherapy and Radiotherapy: A N ew Potential Treatment for Locally Advanced Non-Small Cell Lung Cancer

[ Vol. 12 , Issue. 1 ]

Author(s):

Paola C. Sacco, Paolo Maione, Cesare Guida and Cesare Gridelli Pages 4-10 (7)

Abstract:


Lung cancer is the main reason of cancer death worldwide. About 30% of non-small-cell lung cancer (NSCLC) cases are diagnosed with locally advanced disease (stage III). This is a mixed population including patients who have far more extensive and bulky disease than others. Management of these patients continue to be a challenge; frequently, patients have both local recurrence and distant metastases in this stage and the prognosis is very poor with a 5-year overall survival estimated between 3% and 7% for inoperable disease. The standard treatment for these patients is concurrent chemo-radiotherapy (CRT) improving survival when compared to sequential combination as shown in several metanalysis. Recently, immune-therapies, including checkpoint inhibitor, such as monoclonal antibodies against programmed death receptor 1 (PD-1) and programmed death ligand 1 (PD-L1), have shown to enhance survival compared to chemotherapy in patients with advanced NSCLC. The integration of radiotherapy with immunotherapy is a conceptually promising strategy and several preclinical experiments have further developed the rationale for combining them. Radiotherapy has the capacity to overcome a lot of tumor immune escape mechanisms through the liberation of immunogenic private antigens showing a better local control and augmenting the immune response of systemic agents. This manuscript discusses the potential clinical interest for the combination of radiation and immunotherapy in locally advanced NSCLC.

Keywords:

Immunotherapy, radiotherapy, lung cancer, combining treatment, locally advanced, NSCLC, PD-1 inhibitors, PD-L1 inhibitors, anti-CTLA-4.

Affiliation:

Division of Medical Oncology, "S.G. Moscati" Hospital, Avellino, Division of Medical Oncology, "S.G. Moscati" Hospital, Avellino, Division of Radiotherapy, "S.G.Moscati" Hospital, Avellino, Division of Medical Oncology, "S.G. Moscati" Hospital, Citta Ospedaliera, Contrada Amoretta, 83100 Avellino

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