title: Toxicity of definitive and post-operative radiation following ipilimumab in non-small cell lung cancer.
abstract: To determine the feasibility and toxicity of radiation therapy, delivered either as definitive treatment or following surgery, following neo-adjuvant immune checkpoint inhibition for locally advanced NSCLC sixteen patients who received neo-adjuvant chemotherapy including ipilimumab as part of a phase II study were identified. Patients were analyzed by intent of radiation and toxicity graded based on CTCAE 4.0. There were seven patients identified who received definitive radiation and nine who received post-operative radiation. There was no grade 3 or greater toxicity in the definitive treatment group although one patient stopped treatment early due to back pain secondary to progression outside of the treatment field. In the post-operative treatment group, one patient required a one week break due to grade 2 odynophagia and no grade 3 or greater toxicity was observed. In this study of radiation as definitive or post-operative treatment following neo-adjuvant chemotherapy including ipilimumab for locally advanced NSCLC was feasible and well tolerated with limited toxicity.
authors.affiliation: Department of Radiation Oncology, Duke University, Durham, NC 27710, USA. Electronic address: mjb14@dm.duke.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Boyer
authors.affiliation: Duke Cancer Institute, Department of Biostatistics, Duke University, Durham, NC 27710, USA.
authors.forename: Lin
authors.initials: L
authors.lastname: Gu
authors.affiliation: Duke Cancer Institute, Department of Biostatistics, Duke University, Durham, NC 27710, USA.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Duke University, Durham, NC 27710, USA.
authors.forename: Chris R
authors.initials: CR
authors.lastname: Kelsey
authors.affiliation: Department of Radiation Oncology, Duke University, Durham, NC 27710, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Yoo
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, Duke University, Durham, NC 27710, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Onaitis
authors.affiliation: Department of Medicine, Division of Medical Oncology, Duke University, Durham, NC 27710, USA.
authors.forename: Frank R
authors.initials: FR
authors.lastname: Dunphy
authors.affiliation: Department of Medicine, Division of Medical Oncology, Duke University, Durham, NC 27710, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Crawford
authors.affiliation: Department of Medicine, Division of Medical Oncology, Duke University, Durham, NC 27710, USA.
authors.forename: Neal E
authors.initials: NE
authors.lastname: Ready
authors.affiliation: Department of Radiation Oncology, Duke University, Durham, NC 27710, USA.
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Salama
mesh_terms: D000368:Aged; D000074322:Antineoplastic Agents, Immunological / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D000074324:Ipilimumab / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care / Q000009:adverse effects / Q000379:methods; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000074322:Antineoplastic Agents, Immunological; D000074324:Ipilimumab
keywords: Ipilimumab; Non-small cell lung cancer; Radiation; Toxicity