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Review | Open Access

Chemotherapy-free radiotherapy combined with immune checkpoint inhibitors: a new regimen for locally advanced non-small cell lung cancer?

Lin Ma1,2, Liufu Deng3, Jianfeng Peng2, Jinming Yu1,2( ), Xiangjiao Meng2 ( )
Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430000, China
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China
School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, China
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Abstract

Maintenance immunotherapy after concurrent chemoradiotherapy remains the standard therapeutic approach in patients with unresectable locally advanced non-small cell lung cancer (LA-NSCLC). The efficacy of pembrolizumab without chemotherapy in stage Ⅳ NSCLC has incited interest in similar approaches for LA-NSCLC. Several recent investigations involving the synergistic potential of immunotherapy combined with radiotherapy (iRT) have generated encouraging results. This review discusses the existing studies and prospective directions of chemotherapy-free iRT strategies in unresectable LA-NSCLC. Although the initial findings of chemotherapy-free iRT strategies have shown promising efficacy, we must consider the methodologic limitations of current studies and the myriad of challenges that accompany the implementation of chemotherapy-free iRT. These challenges include determining the optimal dose and fractionation, precise target volume delineation, and identification of additional suitable patient cohorts. Furthermore, the feasibility of chemotherapy-free iRT as a novel treatment modality for select patients with LA-NSCLC is contingent upon validation through randomized phase Ⅲ trials.

Keywords

immunotherapyradiotherapychallengesLocally advanced non-small cell lung cancer (LA-NSCLC)new regimen

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Cancer Biology & Medicine
Volume 20 Issue 12,
December 2023
Pages 1035-1046
DOI: 10.20892/j.issn.2095-3941.2023.0402
Cite this article:
Ma L, Deng L, Peng J, et al. Chemotherapy-free radiotherapy combined with immune checkpoint inhibitors: a new regimen for locally advanced non-small cell lung cancer?. Cancer Biology & Medicine, 2023, 20(12): 1035-1046. https://doi.org/10.20892/j.issn.2095-3941.2023.0402

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Received: 01 November 2023
Accepted: 22 December 2023
Published: 05 February 2024
©2023 Cancer Biology & Medicine.

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