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Effective nivolumab sequential thoracic radiotherapy in elderly patients with advanced squamous cell lung cancer: did radiation therapy play a role? A case report

Authors Lazzari G, Terlizzi A, Porrazzo G, Devicienti S, Perri F, Della Vittoria Scarpati G, Silvano G

Received 4 June 2018

Accepted for publication 10 July 2018

Published 7 August 2018 Volume 2018:11 Pages 4621—4629

DOI https://doi.org/10.2147/OTT.S176226

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 3

Editor who approved publication: Dr Sanjeev Srivastava


Grazia Lazzari,1 Angela Terlizzi,2 Giovanna Porrazzo,1 Salvatore Devicienti,1 Francesco Perri,3 Giuseppina Della Vittoria Scarpati,3 Giovanni Silvano1

1Radiation Oncology Unit, San Giuseppe Moscati Hospital, Taranto, Italy; 2Physics Department, San Giuseppe Moscati Hospital, Taranto, Italy; 3Medical Oncology Department, San Giuseppe Moscati Hospital, Taranto, Italy

Abstract: Advanced squamous cell lung carcinoma in elderly patients has a limited chance of cure with first, second line chemotherapy and radiotherapy. Radiotherapy in advanced non-small-cell lung cancer can be used with curative intent for localized or oligometastatic disease using standard or altered fractionations. Current evidence indicates that radiotherapy via diverse cascade mechanisms is able to invoke both local and systemic immunoresponses promoting tumor cell death through an in situ vaccination effect. Moreover, the advancement in immunotherapies is changing the scenario. The combination of radiotherapy and immunotherapy could be a crucial strategy to overcome cancer immunoresistance and improve patient survival, as we found in this case report of an elderly, refractory advanced lung cancer patient who has achieved complete remission after this therapeutic combination.

Keywords: immunotherapy, anti PD-1 inhibitor, immuno-checkpoint, radiotherapy, in situ vaccination

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