Shingo Miyamoto1, Ryutaro Nomura2, Kengo Sato2, Nobuyasu Awano3, Naoyuki Kuse3, Minoru Inomata3, Takehiro Izumo3, Yuriko Terada4, Yoshiaki Furuhata4, Yuan Bae5, Hideo Kunitoh1. 1. Department of Medical Oncology, Japanese Red Cross Medical Center, Shibuya, Tokyo, Japan. 2. CyberKnife Center, Japanese Red Cross Medical Center, Shibuya, Tokyo, Japan. 3. Department of Respiratory Medicine, Japanese Red Cross Medical Center, Shibuya, Tokyo, Japan. 4. Department of Thoracic Surgery, Japanese Red Cross Medical Center, Shibuya, Tokyo, Japan. 5. Department of Pathology, Japanese Red Cross Medical Center, Shibuya, Tokyo, Japan.
Abstract
BACKGROUND: Radiation therapy might modify the cancer immune environment to enhance the antitumor effect of immune checkpoint inhibitors. We performed a feasibility study of nivolumab following stereotactic radiation therapy for chemotherapy pretreated advanced non-small-cell lung cancer. PATIENTS AND METHODS: Pretreated advanced/recurrent non-small-cell lung cancer patients received stereotactic radiation therapy to one of the disease sites. Nivolumab at a dose of 3 mg/kg was given within 2 weeks after the completion of stereotactic radiation therapy and continued every 2 weeks thereafter until disease progression or unacceptable toxicities. The primary endpoint was the occurrence rate of Grade 3 pneumonitis (within 12 weeks) or other non-hematological toxicity (within 8 weeks). RESULTS: From September 2016 to September 2017, six patients were enrolled. Five received stereotactic radiation therapy to their primary lesions. All patients received nivolumab on the following day after stereotactic radiation therapy completion. Grade 3 pneumonitis occurred in one patient, but no other serious adverse events were reported for the other patients. One complete response and two partial responses were achieved. Four patients had measurable lesions outside the irradiated area, of whom three patients responded to the treatment. The initial progression sites were mainly outside the irradiated field, including one brain metastasis. CONCLUSIONS: Nivolumab therapy immediately following stereotactic radiation therapy was well tolerated. This sequential combination warrants further study.
BACKGROUND: Radiation therapy might modify the cancer immune environment to enhance the antitumor effect of immune checkpoint inhibitors. We performed a feasibility study of nivolumab following stereotactic radiation therapy for chemotherapy pretreated advanced non-small-cell lung cancer. PATIENTS AND METHODS: Pretreated advanced/recurrent non-small-cell lung cancer patients received stereotactic radiation therapy to one of the disease sites. Nivolumab at a dose of 3 mg/kg was given within 2 weeks after the completion of stereotactic radiation therapy and continued every 2 weeks thereafter until disease progression or unacceptable toxicities. The primary endpoint was the occurrence rate of Grade 3 pneumonitis (within 12 weeks) or other non-hematological toxicity (within 8 weeks). RESULTS: From September 2016 to September 2017, six patients were enrolled. Five received stereotactic radiation therapy to their primary lesions. All patients received nivolumab on the following day after stereotactic radiation therapy completion. Grade 3 pneumonitis occurred in one patient, but no other serious adverse events were reported for the other patients. One complete response and two partial responses were achieved. Four patients had measurable lesions outside the irradiated area, of whom three patients responded to the treatment. The initial progression sites were mainly outside the irradiated field, including one brain metastasis. CONCLUSIONS: Nivolumab therapy immediately following stereotactic radiation therapy was well tolerated. This sequential combination warrants further study.
Authors: Sibo Tian; Jeffrey M Switchenko; Zachary S Buchwald; Pretesh R Patel; Joseph W Shelton; Shannon E Kahn; Rathi N Pillai; Conor E Steuer; Taofeek K Owonikoko; Madhusmita Behera; Walter J Curran; Kristin A Higgins Journal: Int J Radiat Oncol Biol Phys Date: 2020-01-24 Impact factor: 7.038
Authors: Rodolfo Chicas-Sett; Ignacio Morales-Orue; Juan Castilla-Martinez; Juan Zafra-Martin; Andrea Kannemann; Jesus Blanco; Marta Lloret; Pedro C Lara Journal: Int J Mol Sci Date: 2019-05-02 Impact factor: 5.923