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Related Concept Videos

Treatment Resistant Cancers02:56

Treatment Resistant Cancers

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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
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Outcomes Following Radiotherapy for Oligoprogressive NSCLC on Immune Checkpoint Inhibitors: A Real-World,

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Radiotherapy combined with immune checkpoint inhibitors shows promising outcomes for non-small cell lung cancer patients with oligoprogressive disease. Higher radiation doses and local response improve survival, guiding clinical decisions.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Immunotherapy

Background:

  • Oligoprogressive disease (OPD) in non-small cell lung cancer (NSCLC) patients on immune checkpoint inhibitors (ICIs) presents unique management challenges.
  • Evaluating radiotherapy (RT) outcomes in this specific patient population is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To conduct the largest multinational review assessing outcomes of RT for NSCLC patients experiencing OPD while on ICIs.
  • To identify predictors of local control (LC), progression-free survival (PFS), and overall survival (OS) in this cohort.

Main Methods:

  • Retrospective analysis of 103 NSCLC patients with OPD irradiated to ≤5 lesions while on ICIs (2010-2023).
  • Statistical analysis included Wilcoxon test, Kaplan-Meier methods, and uni-/multivariate Cox models.
  • Evaluation of patient demographics, disease characteristics, and survival outcomes.

Main Results:

  • Local control (LC) was associated with intermediate/high radiation doses and local response to RT.
  • Improved progression-free survival (PFS) linked to visceral OPD sites post-radiation.
  • Favorable overall survival (OS) associated with intermediate/high radiation doses, local RT response, and duration of ICI therapy before OPD.

Conclusions:

  • Combined ICI and RT demonstrate promising outcomes for visceral OPD in NSCLC, particularly with intermediate/high radiation doses.
  • Prolonged ICI use prior to OPD and achieving a local response to RT significantly improve survival.
  • Findings support multidisciplinary decision-making for managing NSCLC patients with OPD on ICIs.