PMID- 29900043 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210112 IS - 2162-4011 (Print) IS - 2162-402X (Electronic) IS - 2162-4011 (Linking) VI - 7 IP - 7 DP - 2018 TI - Safety and efficacy of concurrent immune checkpoint inhibitors and hypofractionated body radiotherapy. PG - e1440168 LID - 10.1080/2162402X.2018.1440168 [doi] LID - e1440168 AB - Integration of hypofractionated body radiotherapy (H-RT) into immune checkpoint inhibitor (ICI) therapy may be a promising strategy to improve the outcomes of ICIs, although sufficient data is lacking regarding the safety and efficacy of this regimen. We, hereby, reviewed the safety and efficacy of this combination in 59 patients treated with H-RT during or within 8 weeks of ICI infusion and compared results with historical reports of ICI treatment alone. Most patients had RCC or melanoma. Median follow-up was 11 months. Most patients received either Nivolumab alone or with Ipilimumab; 83% received stereotactic RT and 17% received conformal H-RT. Any grade adverse events (AEs) were reported in 46 patients, and grade 3-4 in 12 patients without any treatment-related grade 5 toxicity. The most common grade 3 AEs were fatigue and pneumonitis. Grade 3-4 toxicities were higher with ICI combination and with simultaneous ICIs. Overall, most any-grade or grade >/=3 AE rates did not differ significantly from historically reported rates with single-agent or multi-agent ICIs. Toxicity did not correlate with H-RT site, dose, fraction number, tumor type, or ICI and H-RT sequencing. Median progression-free survival was 6.5 months. Objective response rate (ORR) was 26%; 10% had complete response (CR). Median duration of response was 9.4 +/- 4.6 months. H-RT of lung lesions was more likely to achieve CR than other sites. H-RT of bone lesions had a lower ORR than non-bone H-RT. In conclusion, combining body H-RT with ICIs is safe and promising. Prospective validation is warranted. FAU - Mohamad, Osama AU - Mohamad O AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. FAU - Diaz de Leon, Alberto AU - Diaz de Leon A AD - University of Texas Southwestern Medical Center, Department of Radiology, Dallas, Texas, USA. FAU - Schroeder, Samuel AU - Schroeder S AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. FAU - Leiker, Andrew AU - Leiker A AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. FAU - Christie, Alana AU - Christie A AD - University of Texas Southwestern Medical Center, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Zhang-Velten, Elizabeth AU - Zhang-Velten E AD - University of Texas Southwestern Medical Center, Department of Internal Medicine, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Trivedi, Lakshya AU - Trivedi L AD - University of Texas Southwestern Medical Center, Department of Internal Medicine, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Khan, Saad AU - Khan S AD - University of Texas Southwestern Medical Center, University of Texas Southwestern School of Medicine, Dallas, Texas, USA. FAU - Desai, Neil B AU - Desai NB AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. AD - University of Texas Southwestern Medical Center, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Laine, Aaron AU - Laine A AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. AD - University of Texas Southwestern Medical Center, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Albuquerque, Kevin AU - Albuquerque K AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. FAU - Iyengar, Puneeth AU - Iyengar P AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. FAU - Arriaga, Yull AU - Arriaga Y AD - University of Texas Southwestern Medical Center, University of Texas Southwestern School of Medicine, Dallas, Texas, USA. AD - University of Texas Southwestern Medical Center, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Courtney, Kevin AU - Courtney K AD - University of Texas Southwestern Medical Center, University of Texas Southwestern School of Medicine, Dallas, Texas, USA. AD - University of Texas Southwestern Medical Center, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Gerber, David E AU - Gerber DE AD - University of Texas Southwestern Medical Center, University of Texas Southwestern School of Medicine, Dallas, Texas, USA. FAU - Hammers, Hans AU - Hammers H AD - University of Texas Southwestern Medical Center, University of Texas Southwestern School of Medicine, Dallas, Texas, USA. AD - University of Texas Southwestern Medical Center, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Choy, Hak AU - Choy H AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. FAU - Timmerman, Robert AU - Timmerman R AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. AD - University of Texas Southwestern Medical Center, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Brugarolas, James AU - Brugarolas J AD - University of Texas Southwestern Medical Center, University of Texas Southwestern School of Medicine, Dallas, Texas, USA. AD - University of Texas Southwestern Medical Center, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. FAU - Hannan, Raquibul AU - Hannan R AD - University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA. AD - University of Texas Southwestern Medical Center, Kidney Cancer Program, Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas, USA. LA - eng GR - K24 CA201543/CA/NCI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20180315 PL - United States TA - Oncoimmunology JT - Oncoimmunology JID - 101570526 PMC - PMC5993514 OTO - NOTNLM OT - Immunotherapy OT - Ipilimumab OT - Nivolumab OT - hypofractionation OT - immune checkpoint inhibitors OT - radiation OT - radiotherapy OT - stereotactic radiation EDAT- 2018/06/15 06:00 MHDA- 2018/06/15 06:01 PMCR- 2019/03/15 CRDT- 2018/06/15 06:00 PHST- 2017/12/01 00:00 [received] PHST- 2018/01/20 00:00 [revised] PHST- 2018/02/07 00:00 [accepted] PHST- 2018/06/15 06:00 [entrez] PHST- 2018/06/15 06:00 [pubmed] PHST- 2018/06/15 06:01 [medline] PHST- 2019/03/15 00:00 [pmc-release] AID - 1440168 [pii] AID - 10.1080/2162402X.2018.1440168 [doi] PST - epublish SO - Oncoimmunology. 2018 Mar 15;7(7):e1440168. doi: 10.1080/2162402X.2018.1440168. eCollection 2018.