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Title: Stereotactic ablative radiotherapy combined with immune checkpoint inhibitors reboots the immune response assisted by immunotherapy in metastatic lung cancer: A systematic review
Authors: Chicas-Sett, Rodolfo
Morales-Orue, Ignacio
Castilla-Martinez, Juan
Zafra-Martin, Juan
Kannemann, Andrea
Blanco, Jesus
Lloret Sáez-Bravo, Marta 
Lara, Pedro C.
UNESCO Clasification: 32 Ciencias médicas
Keywords: Abscopal Effect
Immunotherapy, et al
Issue Date: 2019
Journal: International Journal of Molecular Sciences 
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.
ISSN: 1661-6596
DOI: 10.3390/ijms20092173
Source: International Journal of Molecular Sciences [ISSN 1661-6596], v. 20 (9), 2173
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