PMID- 36993952
OWN - NLM
STAT- MEDLINE
DCOM- 20230331
LR  - 20230410
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 14
DP  - 2023
TI  - Safety and efficacy of radiotherapy/chemoradiotherapy combined with immune 
      checkpoint inhibitors for non-small cell lung cancer: A systematic review and 
      meta-analysis.
PG  - 1065510
LID - 10.3389/fimmu.2023.1065510 [doi]
LID - 1065510
AB  - BACKGROUND: It is now widely accepted that radiotherapy (RT) can provoke a 
      systemic immune response, which gives a strong rationale for the combination of 
      RT and immune checkpoint inhibitors (ICIs). However, RT is a double-edged sword 
      that not only enhances systemic antitumor immune response, but also promotes 
      immunosuppression to some extent. Nevertheless, many aspects regarding the 
      efficacy and safety of this combination therapy remain unknown. Therefore, a 
      systematic review and meta-analysis was performed in order to assess the safety 
      and efficacy of RT/chemoradiotherapy (CRT) and ICI combination therapy for 
      non-small cell lung cancer (NSCLC) patients. METHODS: PubMed and several other 
      databases were searched (according to specific criteria) to find relevant studies 
      published prior to the 28(th) of February 2022. RESULTS: 3,652 articles were 
      identified for screening and 25 trials containing 1,645 NSCLC patients were 
      identified. For stage II-III NSCLC, the one- and two-year overall survival (OS) 
      was 83.25% (95% confidence interval (CI): 79.42%-86.75%) and 66.16% (95% CI: 
      62.3%-69.92%), respectively. For stage IV NSCLC, the one- and two-year OS was 50% 
      and 25%. In our study, the pooled rate of grade 3-5 adverse events (AEs) and 
      grade 5 AEs was 30.18% (95% CI: 10.04%-50.33%, I(2): 96.7%) and 2.03% (95% CI: 
      0.03%-4.04%, I(2): 36.8%), respectively. Fatigue (50.97%), dyspnea (46.06%), 
      dysphagia (10%-82.5%), leucopenia (47.6%), anaemia (5%-47.6%), cough (40.09%), 
      esophagitis (38.51%), fever (32.5%-38.1%), neutropenia (12.5%-38.1%), alopecia 
      (35%), nausea (30.51%) and pneumonitis (28.53%) were the most common adverse 
      events for the combined treatment. The incidence of cardiotoxicity (0%-5.00%) was 
      low, but it was associated with a high mortality rate (0%-2.56%). Furthermore, 
      the incidence of pneumonitis was 28.53% (95% CI: 19.22%-38.88%, I(2): 92.00%), 
      grade >/= 3 pneumonitis was 5.82% (95% CI: 3.75%-8.32%, I(2): 57.90%) and grade 5 
      was 0%-4.76%. CONCLUSION: This study suggests that the addition of ICIs to RT/CRT 
      for NSCLC patients may be both safe and feasible. We also summarize details of 
      different RT combinations with ICIs to treat NSCLC. These findings may help guide 
      the design of future trials, the testing of concurrent or sequential combinations 
      for ICIs and RT/CRT could be particularly useful to guide the treatment of NSCLC 
      patients.
CI  - Copyright (c) 2023 Wu, Ni, Deng, Li, Zhong, Tang, Zhang, Fang, Xue, Zha and Zhang.
FAU - Wu, Jing
AU  - Wu J
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
FAU - Ni, Tingting
AU  - Ni T
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
FAU - Deng, Rong
AU  - Deng R
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
FAU - Li, Yan
AU  - Li Y
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
FAU - Zhong, Qin
AU  - Zhong Q
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
FAU - Tang, Fei
AU  - Tang F
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
FAU - Zhang, Qi
AU  - Zhang Q
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
FAU - Fang, Chunju
AU  - Fang C
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
FAU - Xue, Yingbo
AU  - Xue Y
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
FAU - Zha, Yan
AU  - Zha Y
AD  - Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China.
FAU - Zhang, Yu
AU  - Zhang Y
AD  - Department of Medical Oncology, Guizhou Province People's Hospital, Guiyang, 
      China.
AD  - National Health Commission Key Laboratory of Pulmonary Immune-Related Diseases, 
      Guizhou Province People's Hospital, Guiyang, Guizhou, China.
LA  - eng
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20230313
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Humans
MH  - *Carcinoma, Non-Small-Cell Lung/drug therapy
MH  - *Lung Neoplasms/drug therapy
MH  - Immune Checkpoint Inhibitors/adverse effects
MH  - Chemoradiotherapy/adverse effects
MH  - Combined Modality Therapy
PMC - PMC10040597
OTO - NOTNLM
OT  - efficacy
OT  - immune checkpoint inhibitors
OT  - meta-analysis
OT  - non-small cell lung cancer
OT  - radiation therapy
OT  - safety
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/03/31 06:00
MHDA- 2023/03/31 06:41
PMCR- 2023/01/01
CRDT- 2023/03/30 02:58
PHST- 2022/10/09 00:00 [received]
PHST- 2023/02/27 00:00 [accepted]
PHST- 2023/03/31 06:41 [medline]
PHST- 2023/03/30 02:58 [entrez]
PHST- 2023/03/31 06:00 [pubmed]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2023.1065510 [doi]
PST - epublish
SO  - Front Immunol. 2023 Mar 13;14:1065510. doi: 10.3389/fimmu.2023.1065510. 
      eCollection 2023.