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EP1.01 - Advanced NSCLC (ID 150)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
EP1.01-43 - Immunotherapy and Radiotherapy - A Useful Combination? (Now Available) (ID 2984)
08:00 - 18:00 | Presenting Author(s): Stephan Eisenmann
Immunotherapy has emerged as a major and effective therapeutic modality in non-small cell lung cancer (NSCLC). With expanding indications for immunotherapy, therapeutic modalities in progressive disease under immunotherapy are needed.Method
In a retrospective single center analysis patients treated with immunotherapy and radiation for progressive lesions were identified. Both patients with acquired and primary resistance to immunotherapy were included in the analysis.Result
In eight patients (2 adenocarcinoma, 6 SCC) immunotherapy was continued (5 Nivolumab, 1 Pembrolizumab, 2 Atezolizumab) despite disease progression due to good tolerance and missing therapeutic alternatives because of multiple pretreatment regimens and their toxicities. We observed that all 8 patients had a clinical benefit without developing a disseminating disease, we only observed a growth in the previously existing lesions. In 5/8 patients the disease could be stabilized. An abscopal effect could be excluded.
In five patients local metastatic growth was treated with radiation to manage pain and local complications. Three additional patients with asymptomatic, progressive lesions were treated with radiotherapy to prevent organ complications.Conclusion
Immunotherapy has revolutionized NSCLC treatment. However there are therapeutic modalities questioned in progressive disease under immunotherapy. By maintaining immunotherapy during and after radiotherapy localized progression might be effectively treated.
Therefore we summarize that in a number of patients further metastatic evolution might be preventable. Whether peritumoral or systemic prognostic determinants can be identified should be a matter of further research.
Either benefits of local ablative techniques or perpetuation of immunotherapy despite of disease progression were recently reported (Gandara et al. 2018, Gettinger et al. 2018). This also suggests a differentiative perspective of local ablative therapy in metastatic NSCLC.
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