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High-dose irradiation in combination with non-ablative low-dose radiation to treat metastatic disease after progression on immunotherapy: Results of a phase II trial.
Patel, Roshal R; He, Kewen; Barsoumian, Hampartsoum B; Chang, Joe Y; Tang, Chad; Verma, Vivek; Comeaux, Nathan; Chun, Stephen G; Gandhi, Saumil; Truong, Mylene T; Erasmus, Jeremy J; Hong, David S; Lee, Percy P; Ning, Matthew S; Nguyen, Quynh-Nhu; Heymach, John V; Altan, Mehmet; Blumenschein, George; Fossella, Frank V; Sezen, Duygu; Chen, Dawei; Carter, Brett W; Davies, Michael A; Glitza, Isabella C; Diab, Adi; Ferrarotto, Renata; Cabanillas, Maria E; Yuan, Ying; Shah, Shalin J; Parra, Edwin R; Sun, Baohua; Cortez, Maria Angelica; Welsh, James W.
Afiliación
  • Patel RR; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Albany Medical College, Albany, USA.
  • He K; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Departments of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, China.
  • Barsoumian HB; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Chang JY; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Tang C; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Verma V; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Comeaux N; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Chun SG; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Gandhi S; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Truong MT; Departments of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Erasmus JJ; Departments of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Hong DS; Departments of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Lee PP; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Ning MS; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Nguyen QN; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Heymach JV; Departments of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Altan M; Departments of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Blumenschein G; Departments of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Fossella FV; Departments of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Sezen D; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.
  • Chen D; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Albany Medical College, Albany, USA.
  • Carter BW; Departments of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Davies MA; Departments of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Glitza IC; Departments of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Diab A; Departments of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Ferrarotto R; Departments of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Cabanillas ME; Departments of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Yuan Y; Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Shah SJ; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Parra ER; Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Sun B; Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Cortez MA; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
  • Welsh JW; Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: jwelsh@mdanderson.org.
Radiother Oncol ; 162: 60-67, 2021 09.
Article en En | MEDLINE | ID: mdl-34237343
AIM: To report early findings from a phase II trial of high-dose radiotherapy (HD-RT) with or without low-dose RT (LD-RT) for metastatic cancer. METHODS: Eligible patients had metastatic disease that progressed on immunotherapy within 6 months. Patients were given either HD-RT (20-70 Gy total; 3-12.5 Gy/f), or HD-RT + LD-RT (0.5-2 Gy/f up to 1-10 Gy total) to separate lesions, with continued immunotherapy. Radiographic response was assessed per RECIST 1.1 and Immune-Related Response Criteria (irRC). Primary endpoints: (1) 4-month disease control (DCR, complete/partial response [CR/PR] or stable disease [SD]) or an overall response (ORR, CR/PR) at any point in ≥10% of patients, per RECIST 1.1; (2) dose-limiting toxicity within 3 months not exceeding 30%. Secondary endpoint was lesion-specific response. RESULTS: Seventy-four patients (NSCLC, n = 38; melanoma n = 21) were analyzed (39 HD-RT and 35 HD-RT + LD-RT). The median follow-up time was 13.6 months. The primary endpoint was met for 72 evaluable patients, with a 4-month DCR of 42% (47% [16/34] vs. 37% [14/38] in HD-RT + LD-RT vs. HD-RT, P = 0.38), and 19% ORR at any time (26% [9/34] vs. 13% [5/38] in HD-RT + LD-RT vs. HD-RT, P = 0.27). Three patients had toxicity ≥grade 3. LD-RT lesion response (53%) was improved compared to nonirradiated lesions in HD-RT + LD-RT (23%, P = 0.002) and HD-RT (11%, P < 0.001). T- and NK cell infiltration was enhanced in lesions treated with LD-RT. CONCLUSIONS: HD-RT plus LD-RT safely improved lesion-specific response in patients with immune resistant solid tumors by promoting infiltration of effector immune cells into the tumor microenvironment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Primarias Secundarias / Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares Límite: Humans Idioma: En Revista: Radiother Oncol Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Irlanda
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Primarias Secundarias / Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares Límite: Humans Idioma: En Revista: Radiother Oncol Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Irlanda