Combination of SABR With Anti-PD-1 in Oligoprogressive Non-Small Cell Lung Cancer and Melanoma: Results of a Prospective Multicenter Observational Study

Chicas-Sett, Rodolfo; Zafra, Juan; Rodríguez-Abreu, Delvys; Castilla-Martinez, Juan; Benítez, Gretel; Salas, B.; Hernandez, Samuel; Lloret, M.; Onieva, Juan Luis; Barragán, Isabel; Lara, Pedro C.

doi:10.1016/j.ijrobp.2022.05.013

Cited by 28 publications

(28 citation statements)

References 48 publications

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“…Furthermore, in the PEMBRO-RT trial only 1 lesion and in the MDACC trial up to 4 lesions were irradiated, whereas in this current study up to 5 metastatic lesions where irradiated. A comparison between these response rates is therefore very unreliable and could lead to an overestimation of the response rate of Chicas-Sett et al (11). Nevertheless, their overall response rate of 42% remains auspicious and could be of real clinical importance.…”

Section: Editorial Commentarymentioning

confidence: 97%

“…An important emerging clinical question is whether 7 Gy in 5 fractions (fx), with an equivalent dose in 2 Gy fractions (EQD2) (α/β=3) of 70, is the right SABR dose used to treat the progressive lesions (11). Although the authors report that most lesions were thoracic, with corresponding dose-limiting constraints, it can be debated if this is the optimal dose.…”

Section: Editorial Commentarymentioning

confidence: 99%

“…In the International Journal of Radiation Oncology, Biology, Physics, Chicas-Sett et al report the results of a prospective multicenter observational study on the combination of SABR with anti-PD-1 ICI in 31 (62%) NSCLC and 19 (38%) melanoma patients (11). All patients were treated concurrently with SABR for 1-5 oligoprogressive lesions during treatment with pembrolizumab or nivolumab, and continued the same anti-PD-1 treatment until further progression, unacceptable toxicity, or medical/patient decision.…”

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confidence: 99%

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Efficacy of stereotactic ablative radiotherapy (SABR) during anti-PD-1 in oligoprogressive non-small cell lung cancer and melanoma—a prospective multicenter observational study pointing out new unmet needs

Damen¹,

Verhoeff²

2023

Transl Cancer Res

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Section: Editorial Commentarymentioning

confidence: 97%

Section: Editorial Commentarymentioning

confidence: 99%

mentioning

confidence: 99%

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Efficacy of stereotactic ablative radiotherapy (SABR) during anti-PD-1 in oligoprogressive non-small cell lung cancer and melanoma—a prospective multicenter observational study pointing out new unmet needs

Damen¹,

Verhoeff²

2023

Transl Cancer Res

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“…Stereotactic ablative radiotherapy (SABR) is an effective treatment for oligometastatic disease ( 10 ). Recently, several studies have reported results on its promising combination with immunotherapy and TT ( 11 – 13 ). Various clinical guidelines recommend the use of SABR in oligometastatic or oligoprogressive patients with driver mutations ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Stereotactic ablative radiotherapy for acquired resistance to EGFR therapy in metastatic non-small cell lung cancer

Chicas-Sett¹,

Martínez²,

Blanquisett³

et al. 2023

Front. Oncol.

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The advent of targeted therapy has transformed the treatment paradigm and survival of patients with metastatic non-small cell lung cancer (NSCLC) with driver mutations. The development of acquired resistances during treatment with tyrosine kinase inhibitors (TKIs) impedes a prolonged survival in many patients. This fact is leading to the use of locally ablative therapies such as stereotactic ablative radiotherapy (SABR) to counter these resistances. SABR is a non-invasive treatment that can be delivered in multiple locations and has already proven effective in oligometastatic disease. Clinical evidence suggests that the combination of SABR with TKIs prolongs progression-free survival (PFS) in metastatic NSCLC patients with mutations in epidermal growth factor receptor (EGFR), with international guidelines recommending their use in unfavorable scenarios such as oligoprogressive disease. In this publication, we have reviewed the available evidence on EGFR-TKIs resistance mechanisms and the combination of SABR with TKI in metastatic NSCLC with EGFR mutations. We also describe the utility and clinical recommendations of this combination in oligometastatic and oligoprogressive disease.

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“…Local consolidative therapy is an interesting topic for the treatment of oligo-progressive sites, and it has been increasingly provided in clinical practice. A wealth of research has demonstrated the essential role of local cancer treatments in improving survival among NSCLC patients with oligo-progressive or oligometastic disease [11][12][13]. Radiotherapy has immunomodulatory qualities capable of augmenting antitumor immune responses, making the integration of radiotherapy with immunotherapy a new therapeutic option in advanced NSCLC [14,15].…”

Section: Introductionmentioning

confidence: 99%

Atypical Response in Metastatic Non-Small Cell Lung Cancer Treated with PD-1/PD-L1 Inhibitors: Radiographic Patterns and Clinical Value of Local Therapy

Jiang

Zhang

Chu

et al. 2022

Cancers

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Purpose: To explore the clinical characteristics, management, and survival outcomes of advanced NSCLC patients treated with PD-1/PD-L1 inhibitors who presented with an atypical response (AR). Methods: A total of 926 PD-1/PD-L1-inhibitor-treated patients with metastatic NSCLC from three academic centers were retrospectively reviewed. All measurable lesions were evaluated by RECIST version 1.1. Results: Fifty-six (6.1%) patients developed AR. The median time to the occurrence of AR was 2.0 months. Patients with no fewer than 3 metastatic organs at baseline were more prone to develop AR in advanced NSCLC (p = 0.038). The common sites of progressive lesions were lymph nodes (33.8%) and lungs (29.7%). The majority (78.2%) of patients with AR had only 1–2 progressive tumor lesions, and most (89.1%) of the progressive lesions developed from originally existing tumor sites. There was no significance in terms of survival between patients with AR and those with typical response (TR). Local therapy was an independent predictor for PFS of patients with AR (p = 0.025). Conclusions: AR was not an uncommon event in patients with metastatic NSCLC treated with PD-1/PD-L1 inhibitors, and it had a comparable prognosis to those with TR. Proper local therapy targeting progressive lesions without discontinuing original PD-1/PD-L1 inhibitors may improve patient survival.

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Combination of SABR With Anti-PD-1 in Oligoprogressive Non-Small Cell Lung Cancer and Melanoma: Results of a Prospective Multicenter Observational Study

Cited by 28 publications

References 48 publications

Efficacy of stereotactic ablative radiotherapy (SABR) during anti-PD-1 in oligoprogressive non-small cell lung cancer and melanoma—a prospective multicenter observational study pointing out new unmet needs

Efficacy of stereotactic ablative radiotherapy (SABR) during anti-PD-1 in oligoprogressive non-small cell lung cancer and melanoma—a prospective multicenter observational study pointing out new unmet needs

Stereotactic ablative radiotherapy for acquired resistance to EGFR therapy in metastatic non-small cell lung cancer

Atypical Response in Metastatic Non-Small Cell Lung Cancer Treated with PD-1/PD-L1 Inhibitors: Radiographic Patterns and Clinical Value of Local Therapy

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