1. 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.
- Author
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Nguyen, Nam P., Page, Brandi R., Giap, Huan, Dahbi, Zineb, Vinh-Hung, Vincent, Gorobets, Olena, Mohammadianpanah, Mohammad, Motta, Micaela, Portaluri, Maurizio, Arenas, Meritxell, Bonet, Marta, Lara, Pedro Carlos, Kim, Lyndon, Dutheil, Fabien, Natoli, Elena, Loganadane, Gokoulakrichenane, Lehrman, David, Bose, Satya, Kaur, Sarabjot, and Blanco, Sergio Calleja
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MEDICAL protocols , *CANCER relapse , *PATIENT safety , *IMMUNOTHERAPY , *PROGRAMMED death-ligand 1 , *ADJUVANT treatment of cancer , *FRAIL elderly , *TUMOR markers , *CHEMORADIOTHERAPY , *INTERNATIONAL agencies , *IMMUNE checkpoint inhibitors , *CANCER chemotherapy , *COMBINED modality therapy , *DRUG efficacy , *LUNG cancer , *DISEASE progression , *OVERALL survival , *DRUG tolerance , *OLD age ,BODY fluid examination - Abstract
Simple Summary: Older patients with locally advanced non-small cell lung cancer may not be candidates for standard treatment due to their poor performance status. Immunotherapy and radiotherapy are well tolerated and may become the treatment of choice for those patients. This hypothesis should be confirmed in future clinical trials. 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. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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