title: The Combination of New Immunotherapy and Radiotherapy: A N ew Potential Treatment for Locally Advanced Non-Small Cell Lung Cancer.
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.
authors.affiliation: Division of Medical Oncology, "S.G. Moscati" Hospital, Avellino, Italy.
authors.forename: Paola C
authors.initials: PC
authors.lastname: Sacco
authors.affiliation: Division of Medical Oncology, "S.G. Moscati" Hospital, Avellino, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Maione
authors.affiliation: Division of Radiotherapy, "S.G.Moscati" Hospital, Avellino, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Guida
authors.affiliation: Division of Medical Oncology, "S.G. Moscati" Hospital, Citta Ospedaliera, Contrada Amoretta, 83100 Avellino, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Gridelli
mesh_terms: D000818:Animals; D000074322:Antineoplastic Agents, Immunological / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008175:Lung Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016246:Lymphocytes, Tumor-Infiltrating / Q000187:drug effects / Q000276:immunology; D058990:Molecular Targeted Therapy; D009367:Neoplasm Staging; D011829:Radiation Dosage; D016499:Radioimmunotherapy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome; D019139:Tumor Escape / Q000187:drug effects
chemical_list: D000074322:Antineoplastic Agents, Immunological
keywords: Immunotherapy; NSCLC; PD-1 inhibitors; PD-L1 inhibitors; anti-CTLA-4; combining treatment; locally advanced; lung cancer; radiotherapy