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

Abstract

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

Keywords

• immunotherapy
• anti PD-1 inhibitor
• immuno-checkpoint
• radiotherapy
• in situ vaccination