Radiation and PD-1 inhibition: Favorable outcomes after brain-directed radiation
| Autor: | Luke R.G. Pike, Monica Krishnan, Alexander Spektor, Brian M. Alexander, Andrew Bang, F. Stephen Hodi, Patrick A. Ott, Paul J. Catalano, Allison Taylor, Mark M. Awad, Tracy A. Balboni, Bhupendra Rawal, Ayal A. Aizer, Daniel N. Cagney, Elizabeth I. Buchbinder, Leena Gandhi, Jonathan D. Schoenfeld |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Oncology Male medicine.medical_specialty Palliative Radiation Therapy medicine.medical_treatment Population Programmed Cell Death 1 Receptor 03 medical and health sciences 0302 clinical medicine Renal cell carcinoma Internal medicine Neoplasms medicine Humans Radiology Nuclear Medicine and imaging education Aged Retrospective Studies education.field_of_study business.industry Brain Neoplasms Melanoma Hematology Immunotherapy Chemoradiotherapy Middle Aged medicine.disease Immune checkpoint Blockade Surgery Radiation therapy 030104 developmental biology 030220 oncology & carcinogenesis Cranial Irradiation business |
| Zdroj: | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 124(1) |
| ISSN: | 1879-0887 |
| Popis: | Background and purpose Patients with metastatic melanoma, renal cell carcinoma (RCC) and non-small cell lung cancer (NSCLC) are increasingly treated with immune checkpoint blockade targeting the programed death (PD)-1 receptor, often with palliative radiation therapy. Outcome data are limited in this population. Material and methods We retrospectively reviewed consecutive patients with metastatic NSCLC, melanoma, and RCC who received radiation and anti-PD-1 therapy at four centers. Results We identified 137 patients who received radiation and PD-1 inhibition. Median survival from first PD-1 therapy was 192, 394, and 121 days for NSCLC, melanoma, and RCC patients. Among 59 patients who received radiation following the start of PD-1 blockade, 25 continued to receive PD-1 inhibition for a median of 179 days and survived for a median of 238 additional days. Median survival following first course of radiation for brain metastases was 634 days. Melanoma patients received brain directed radiation relatively less frequently following the start of PD-1 inhibitor treatment. Conclusions Incorporation of palliative radiation does not preclude favorable outcomes in patients treated with PD-1 inhibitors; patients irradiated after the start of PD-1 inhibition can remain on therapy and demonstrate prolonged survival. Of note, patients irradiated for brain metastases demonstrate favorable outcomes compared with historical controls. |
| Databáze: | OpenAIRE |
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