Study Design and Rationale for Espera Trial: A Multicentre, Randomized, Phase II Clinical Trial Evaluating the Potential Efficacy of Adding SBRT to Pembrolizumab-Pemetrexed Maintenance in Responsive or Stable Advanced Non-Squamous NSCLC After Chemo-Immunotherapy Induction

Belluomini, Lorenzo; Dionisi, Valeria; Palmerio, Silvia; Vincenzi, Sofia; Avancini, Alice; Casali, M.; Riva, Silvia Teresa; Menis, Jessica; Mazzarotto, Renzo; Pilotto, Sara; Milella, Michèle

doi:10.1016/j.cllc.2021.07.004

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…The study suggested that irradiation improved the median OS from 8.7 to 19.2 months compared to immunotherapy alone and, furthermore, increased the abscopal response rates from 19.7% to 41.7% and the abscopal control rate from 43.4% to 65.3% [31]. Results of other interestingly designed trials await the confirmation of the efficacy of metastatic lesion irradiation in triggering abscopal effects during immunotherapy for NSCLC [32,33].…”

Section: Discussionmentioning

confidence: 90%

Ultra-Hypofractionated Re-Irradiation with Anti-PD-1 Immunotherapy for Locoregionally Recurrent (after Radical Chemo-Radiotherapy) Non-Small Cell Lung Cancer

Filippatos,

Koukourakis,

Anevlavis

et al. 2023

Cancers

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Large fractions of radiotherapy of 8 Gy (ultra-hypofractionated RT, ultra-hypoRT) promote anti-tumor immune responses that have been clinically substantiated in combination trials with immune checkpoint inhibitors (ICIs). In the current study, we postulated that ultra-hypoRT in combination with ICIs may enhance tumor clearance in NSCLC patients with locoregional relapse after radical chemo-RT. Between 2019 and 2021, eleven patients received re-irradiation with one or two fractions of 8 Gy concurrently with anti-PD1 immunotherapy (nivolumab or pembrolizumab). RT-related toxicities were negligible, while immune-related adverse events enforced immunotherapy interruption in 36% of patients. The overall response rate was 81.8%. Tumor reduction between 80 and 100% was noted in 63.5% of patients. Within a median follow-up of 22 months, the locoregional relapse-free rate was 54.5%, while the projected 2-year disease-specific overall survival was 62%. The results were independent of PD-L1 status. The current report provides encouraging evidence that a relatively low biological dose of RT delivered with 8 Gy fractions is feasible and can be safely combined with anti-PD-1 immunotherapy. Despite the low number of patients, the significant tumor regression achieved and the long-lasting locoregional control and overall progression-free intervals provide a basis to pursue immuno-RT trials with U-hypoRT schemes in this group of NSCLC patients of poor prognosis.

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Section: Discussionmentioning

confidence: 90%

Ultra-Hypofractionated Re-Irradiation with Anti-PD-1 Immunotherapy for Locoregionally Recurrent (after Radical Chemo-Radiotherapy) Non-Small Cell Lung Cancer

Filippatos,

Koukourakis,

Anevlavis

et al. 2023

Cancers

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“…In several phase II trials, SBRT following chemotherapy or targeted therapy has been shown to improve survival outcomes in oligometastatic NSCLC patients ( 57 – 59 ). Ongoing RCTs are exploring whether SBRT improves survival in patients receiving maintenance therapy ( 60 , 61 ). For second-line treatment of oligometastatic NSCLC, combining SBRT with targeted agents led to a median PFS of 14.7 months and a median OS of 20.4 months, which warrants further exploration ( 62 ).…”

Section: Local Ablative Therapies For Oligometastatic Nsclc In the Pr...mentioning

confidence: 99%

Combining stereotactic body radiotherapy with immunotherapy in stage IV non-small cell lung cancer

Liu,

Chi

2023

Front. Oncol.

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Immunotherapy has revolutionized the treatment of metastatic non-small cell lung cancer (NSCLC). Oligometastasis has been associated with better prognosis than widespread metastatic disease and may be curable by stereotactic body radiotherapy (SBRT). SBRT can stimulate immunogenic anti-tumor activity, which can be further augmented when combined with immunotherapy, such as immune checkpoint inhibitors (ICIs). Thus, its combination with immunotherapy was recognized as a promising treatment option, especially in the metastatic setting. However, the most optimal approach to combine SBRT with immunotherapy remains controversial with early clinical evidence emerging. Here, we review the current clinical evidence supporting the combination of SBRT with immunotherapy in the treatment of metastatic NSCLC. Also, we discuss the current controversies and areas for further exploration associated with this treatment strategy.

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“…A randomized phase 3 trial evaluated durvalumab and tremelimumab plus SBRT for relapsed SCLC, but the efficacy was disappointing (98). Multiple trials are ongoing to further evaluate SBRT plus ICIs for lung cancer (99)(100)(101).…”

Section: Radiotherapy Plus Icismentioning

confidence: 99%

Research landscape and trends of lung cancer radiotherapy: A bibliometric analysis

Liu

Jiang²,

Lin³

et al. 2022

Front. Oncol.

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Backgroundradiotherapy is one of the major treatments for lung cancer and has been a hot research area for years. This bibliometric analysis aims to present the research trends on lung cancer radiotherapy.MethodOn August 31, 2022, the authors identified 9868 articles on lung cancer radiotherapy by the Web of Science (Science Citation Indexing Expanded database) and extracted their general information and the total number of citations. A bibliometric analysis was carried out to present the research landscape, demonstrate the research trends, and determine the most cited papers (top-papers) as well as top-journals on lung cancer radiotherapy. After that, the authors analyzed the recent research hotspots based on the latest publications in top-journals.ResultsThese 9868 papers were cited a total of 268,068 times. “Durvalumab after chemoradiotherapy in stage III non–small-cell lung cancer” published in 2017 by Antonia et al.was the most cited article (2110 citations). Among the journals, New England Journal of Medicine was most influential. Moreover, J. Clin. Oncol. and Int. J. Radiat. Oncol. Biol. Phys. was both influential and productive. Corresponding authors represented the USA (2610 articles) and China mainland (2060 articles) took part in most publications and articles with corresponding authors from Netherlands were most cited (46.12 citations per paper). Chemoradiotherapy was the hottest research area, and stereotactic body radiotherapy has become a research hotspot since 2006. Radiotherapy plus immunotherapy has been highly focused since 2019.ConclusionsThis bibliometric analysis comprehensively and quantitatively presents the research trends and hotspots based on 9868 relevant articles, and further suggests future research directions. The researchers can benefit in selecting journals and in finding potential collaborators. This study can help researchers gain a comprehensive picture of the research landscape, historical development, and recent hotspots in lung cancer radiotherapy and can provide inspiration for future research.

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Study Design and Rationale for Espera Trial: A Multicentre, Randomized, Phase II Clinical Trial Evaluating the Potential Efficacy of Adding SBRT to Pembrolizumab-Pemetrexed Maintenance in Responsive or Stable Advanced Non-Squamous NSCLC After Chemo-Immunotherapy Induction

Cited by 4 publications

References 11 publications

Ultra-Hypofractionated Re-Irradiation with Anti-PD-1 Immunotherapy for Locoregionally Recurrent (after Radical Chemo-Radiotherapy) Non-Small Cell Lung Cancer

Ultra-Hypofractionated Re-Irradiation with Anti-PD-1 Immunotherapy for Locoregionally Recurrent (after Radical Chemo-Radiotherapy) Non-Small Cell Lung Cancer

Combining stereotactic body radiotherapy with immunotherapy in stage IV non-small cell lung cancer

Research landscape and trends of lung cancer radiotherapy: A bibliometric analysis

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