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Immunotherapy and radiotherapy in locally advanced (metastatic) non small cell lung cancer

Publication at First Faculty of Medicine, Faculty of Medicine in Pilsen |
2020

Abstract

Non small cell lung cancer even today is a big socioeconomic problem for beeing diagnosed in an advanced or metastatic stage in majority of tumors when our treatment methods available at that time unfortunately are not associated with satisfactory results except few patients with tumors carrying specific mutations. Radiochemotherapy remains the basic standard regimen while adding induction or maintenance cytotoxic treatment did not count for any other benefit.

However, modern immunotherapy by PD 1 and PD L1 inhibitors brings a huge hope today. Mainly it's combination with radiation therapy sensibilizing to a better immunotherapy effect could become a standard part in majority of treatment guidelines.

In this context, hypofractionated radiation regimens with limited target volumes seem to be preferred to normofractionation and larger fields. The role of abscopal effect remains still uncertain.