Bassanelli Maria, Ramella Sara, Zeuli Massimo, Ceribelli Anna
Medical Oncology 1-IRCCS Regina Elena National Cancer Institute, Rome, Italy;
Radiation Oncology -Campus Bio-Medico University, Rome, Italy.
Anticancer Res. 2022 May;42(5):2241-2247. doi: 10.21873/anticanres.15704.
Immune checkpoint inhibitors (ICPi) targeting programmed cell death 1(PD-1)/programmed cell death ligand-1 (PD-L1) have revolutionized the treatment of patients with advanced non-small cell lung cancer (NSCLC). Despite impressive success, only a small proportion of patients benefit from PD1/PDL1 inhibitors. Radiotherapy (RT) can induce a systemic anti-tumor immune response on local and distant tumors. Some preclinical and clinical evidence showed a critical role of RT to overcome acquired resistance to immunotherapy. Currently, durvalumab consolidation represents the new standard treatment for unresectable stage III NSCLC patients whose tumors express PDL1 on ≥1% of tumor cells (TC), and whose disease has not progressed following platinum-based chemoradiotherapy (CRT). In this review, we focus on the synergic effect of RT with ICPi and the new role that different RT schedules can play in combination with immunotherapy for early-stage NSCLC.
靶向程序性细胞死亡蛋白1（PD-1）/程序性细胞死亡配体1（PD-L1）的免疫检查点抑制剂（ICPi）彻底改变了晚期非小细胞肺癌（NSCLC）患者的治疗方式。尽管取得了令人瞩目的成功，但只有一小部分患者能从PD1/PDL1抑制剂中获益。放射治疗（RT）可对局部和远处肿瘤诱导全身性抗肿瘤免疫反应。一些临床前和临床证据表明，RT在克服免疫治疗获得性耐药方面起着关键作用。目前，度伐利尤单抗巩固治疗是不可切除的III期NSCLC患者的新标准治疗方案，这些患者的肿瘤细胞（TC）中≥1%表达PDL1，且在铂类同步放化疗（CRT）后疾病未进展。在本综述中，我们重点关注RT与ICPi的协同作用，以及不同RT方案在与免疫治疗联合用于早期NSCLC时可发挥的新作用。
