Immunotherapy and Radiotherapy for Older Patients with Locally Advanced Non-Metastatic Non-Small-Cell Lung Cancer Who Are Not Candidates for or Decline Surgery and Chemotherapy: A Practical Proposal by the International Geriatric Radiotherapy Group
The standard of care for locally advanced non-small-cell lung cancer (NSCLC) is either surgery combined with chemotherapy pre- or postoperatively or concurrent chemotherapy and radiotherapy. However, older and frail patients may not be candidates for surgery and chemotherapy due to the high mortality risk and are frequently referred to radiotherapy alone, which is better tolerated but carries a high risk of disease recurrence. Recently, immunotherapy with immune checkpoint inhibitors (ICIs) may induce a high response rate among cancer patients with positive programmed death ligand 1 (PD-L1) expression. Immunotherapy is also well tolerated among older patients. Laboratory and clinical studies have reported synergy between radiotherapy and ICI. The combination of ICI and radiotherapy may improve local control and survival for NSCLC patients who are not candidates for surgery and chemotherapy or decline these two modalities. The International Geriatric Radiotherapy Group proposes a protocol combining radiotherapy and immunotherapy based on the presence or absence of PD-L1 to optimize the survival of those patients.
Authors
- Gokoulakrichenane Loganadane (ORCID: https://orcid.org/0000-0003-3986-2612)
- Huan Giap (ORCID: https://orcid.org/0000-0002-7294-9085)
- Pedro C. Lara (ORCID: https://orcid.org/0000-0003-1709-6232)
- Alexander Chi (ORCID: https://orcid.org/0000-0002-9763-5867)
- B.R. Page (ORCID: https://orcid.org/0000-0002-1770-099X)
- Micaela Motta
- Marta Bonet (ORCID: https://orcid.org/0000-0002-6417-0514)
- Nam P. Nguyen (ORCID: https://orcid.org/0000-0001-5106-6665)
- Μohammad Mohammadianpanah (ORCID: https://orcid.org/0000-0001-9391-8977)
- Maurizio Portaluri (ORCID: https://orcid.org/0000-0002-8777-5997)
- Meritxell Arenas (ORCID: https://orcid.org/0000-0003-0815-2570)
- S. Bose
- Lyndon Kim
- S Kaur (ORCID: https://orcid.org/0000-0001-6646-5562)
- Fabien Dutheil
- Olena Gorobets (ORCID: https://orcid.org/0000-0003-2589-092X)
- David Lehrman
- Sergio Calleja Blanco
- Zineb Dahbi (ORCID: https://orcid.org/0000-0002-8290-7532)
- Vincent Vinh‐Hung (ORCID: https://orcid.org/0000-0002-6403-6120)
- Elena Natoli
Institutions
- Howard University (US)
- Johns Hopkins University (US)
- Capital Medical University (CN)
- Shiraz University of Medical Sciences (IR)
- Hospital Universitari Arnau de Vilanova (ES)
- Universidad Fernando Pessoa Canarias (ES)
- Mount Sinai Hospital (US)
- Ospedale Papa Giovanni XXIII (IT)
- Azienda USL di Bologna (IT)
- Université Mohammed VI des Sciences et de la Santé (MA)
- Illinois CancerCare (US)
- Centre Hospitalier Public du Cotentin (FR)
- Hospital Universitari Sant Joan de Reus (ES)
- Institut Curie (FR)
- University of Bologna (IT)
Publication Details
- Journal
- Cancers
- Published
- 2024-09-09
- DOI
- https://doi.org/10.3390/cancers16173112
- Citations
- 7
- Primary Topic
- Cancer Immunotherapy and Biomarkers
- Type
- article
- Field-Weighted Citation Impact
- 1.98