Is radiotherapy the missing link to enhancing the outcomes in non-small cell lung cancer patients treated with immunotherapy?

Ritchell van Dams, David Raben, Percy Lee


Significant improvements in outcomes for locally advanced and metastatic non-small cell lung cancer (NSCLC) have been seen with increased use of immune checkpoint inhibitors (ICIs), and their role in the treatment of early-stage NSCLC is a subject of active investigation. Mounting evidence from preclinical and clinical trials involving immunotherapy for NSCLC has demonstrated the importance of understanding the tumor microenvironment (TME) and the host anti-tumor response. Incorporation of radiation, specifically in hypofractionated regimens, may potentiate the anti-tumor response stimulated by ICIs and thereby improve the efficacy of immunotherapy for these patients. Additional studies are in progress to determine the optimal sequence, dose, fractionation, and duration of combination therapy.