Retrospective Review of Outcomes After Radiation Therapy for Oligoprogressive Disease on Immune Checkpoint Blockade.

Autor:	Mahmood U; Department of Radiation Oncology., Huynh MA; Department of Radiation Oncology., Killoran JH; Department of Radiation Oncology., Qian JM; Department of Radiation Oncology., Bent EH; Department of Radiation Oncology., Aizer AA; Department of Radiation Oncology., Mak RH; Department of Radiation Oncology., Mamon HJ; Department of Radiation Oncology., Balboni TA; Department of Radiation Oncology., Gunasti L; Department of Radiation Oncology., Ott PA; Melanoma Disease Center., Awad MM; Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Schoenfeld JD; Department of Radiation Oncology. Electronic address: jonathan_schoenfeld@dfci.harvard.edu.
Jazyk:	angličtina
Zdroj:	International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2022 Nov 15; Vol. 114 (4), pp. 666-675. Date of Electronic Publication: 2022 May 26.
DOI:	10.1016/j.ijrobp.2022.05.008
Abstrakt:	Purpose: We retrospectively evaluated outcomes after radiation therapy for patients with oligoprogression on immune checkpoint inhibitors (ICI). Methods and Materials: We identified patients irradiated to ≤5 progressive lesions while receiving ICI between 2010 and 2020. We excluded patients whose systemic therapy was switched after radiation but before progression. We evaluated predictors of local control (LC), progression-free survival (PFS) and overall survival (OS). Results: We screened 1423 patients and identified 120 who were eligible; the most common histologies were lung cancer (n = 59) and melanoma (n = 36). The median number of oligoprogressive lesions was 1. For the median LC of irradiated oligoprogressive lesions, PFS and OS were not reached at 6.41 (4.67-7.66) and 29.80 (22.54-43.33) months, respectively. Tumor histology, radiated site, or radiation modality were not associated with LC, PFS, or OS. Local response to radiation (P < .0001) and radiation of newly developed lesions (P = .02) were associated with LC. Predictors of PFS on univariate and multivariate analyses were best response to radiation (P = .006) and high programmed death ligand 1 tumor proportion score (P = .02). On multivariate analyses, OS was associated with cumulative oligoprogressive lesion volumes (P = .02) and duration of ICI before oligoprogression (P = .03). Conclusions: Promising outcomes were observed among patients irradiated for oligoprogression on ICI, especially those with a favorable local response, high tumor programmed death ligand 1 expression, and those receiving ICI for longer periods before oligoprogression. These data can help identify patients well suited for radiation therapy versus those who should switch systemic treatment. (Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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