Toxicity of concurrent stereotactic radiotherapy and targeted therapy or immunotherapy: A systematic review

Kroeze, S.G.C.; Fritz, Corinna; Høyer, Morten; Lo, Simon S.; Ricardi, Umberto; Sahgal, Arjun; Stahel, Rolf A.; Stupp, Roger; Gückenberger, Matthias

doi:10.1016/j.ctrv.2016.11.013

Cited by 171 publications

(98 citation statements)

References 62 publications

(137 reference statements)

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“…Although targeted therapy shows great promise, the biggest concern is acquired resistance at which point the therapy loses its efficacy (12). There is limited data in regards to concurrent SABR and targeted therapy, so it is difficult to say at this time if such a treatment course is appropriate for patients without risking undue toxicity from co-administration (13). EGFR inhibitors in particular have been reported to have possibility of pulmonary toxicity which may limit ability to be employed concurrently with radiation therapy (14).…”

mentioning

confidence: 99%

Utility of stereotactic ablative radiotherapy/stereotactic body radiation therapy in the setting of oligometastatic non-small cell lung cancer

Song

Lü

2018

J. Thorac. Dis.

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mentioning

confidence: 99%

Utility of stereotactic ablative radiotherapy/stereotactic body radiation therapy in the setting of oligometastatic non-small cell lung cancer

Song

Lü

2018

J. Thorac. Dis.

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“…This is further supported by preclinical findings suggesting a radio-sensitizing effect of Vemurafenib [45, 61]. On the other hand, increased side effects such as skin symptoms have been reported for the combination, thus potentially limiting the clinical applicability [1, 29]. Based on these data, BRAF inhibitors should probably be paused during the radiotherapy.…”

Section: Braf Tyrosine Kinase Inhibitorsmentioning

confidence: 68%

Targeted Therapies for Melanoma Brain Metastases

Berghoff

2017

Curr Treat Options Neurol

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Opinion statementBrain metastases are a major clinical challenge occurring in up to 60% of patients suffering from metastatic melanoma. They cause significant clinical symptoms and impair the overall survival prognosis. The introduction of targeted therapies including BRAF and MEK inhibitors as well as CTLA-4 and PD-1 axis targeting immune checkpoint inhibitors have dramatically improved the treatment and prognosis of patients with extracranial metastatic melanoma. Although, similar response rates for extra- and intracranial metastases have been reported, only few data from brain metastasis specific trails are available so far. The following review will provide an overview on the currently available data on targeted therapies, remaining questions and the most important side effects in the special clinical situation of melanoma brain metastases.

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“…60,157,158 SBRT is theoretically less systemically immunosuppressive than conventional radiation, in which patients have circulating lymphocytes that may be irradiated over 5 to 6 weeks. 60,126 Early studies have demonstrated that immunotherapy and radiation can safely be administered together and may induce responses, [159][160][161][162] but questions remain regarding the optimal timing of systemic treatment with radiation, radiation dose, and tumour volume irradiated. 60,126,163 Recent work in human sarcomas has suggested that radiation upregulates common targets of recently approved immune checkpoint inhibitors such as PD-L1.…”

Section: Rt and Immunotherapy For Sarcomasmentioning

confidence: 99%

Emerging therapeutic approaches for canine sarcomas: Pushing the boundaries beyond the conventional

Borgatti

Dickerson

Lawrence

2019

Vet Comparative Oncology

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Sarcomas represent a group of genomically chaotic, highly heterogenous tumours of mesenchymal origin with variable mutational load. Conventional therapy with surgery and radiation therapy is effective for managing small, low‐grade sarcomas and remains the standard therapeutic approach. For advanced, high‐grade, recurrent, or metastatic sarcomas, systemic chemotherapy provides minimal benefit, therefore, there is a drive to develop novel approaches. The discovery of “Coley's toxins” in the 19th century, and their use to stimulate the immune system supported the application of unconventional therapies for the treatment of sarcomas. While promising, this initial work was abandoned and treatment paradigm and disease course of sarcomas was largely unchanged for several decades. Exciting new therapies are currently changing treatment algorithms for advanced carcinomas and melanomas, and similar approaches are being applied to advance the field of sarcoma research. Recent discoveries in subtype‐specific cancer biology and the identification of distinct molecular targets have led to the development of promising targeted strategies with remarkable potential to change the landscape of sarcoma therapy in dogs. The purpose of this review article is to describe the current standard of care and limitations as well as emerging approaches for sarcoma therapy that span many of the most active paradigms in oncologic research, including immunotherapies, checkpoint inhibitors, and drugs capable of cellular metabolic reprogramming.

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Toxicity of concurrent stereotactic radiotherapy and targeted therapy or immunotherapy: A systematic review

Abstract: This review gives a best-possible overview of current knowledge and its limitations and underlines the need for a timely generation of stronger evidence in this rapidly expanding field.

Cited by 171 publications

References 62 publications

Utility of stereotactic ablative radiotherapy/stereotactic body radiation therapy in the setting of oligometastatic non-small cell lung cancer

Utility of stereotactic ablative radiotherapy/stereotactic body radiation therapy in the setting of oligometastatic non-small cell lung cancer

Targeted Therapies for Melanoma Brain Metastases

Emerging therapeutic approaches for canine sarcomas: Pushing the boundaries beyond the conventional

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