Trial reportRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2021
High-dose irradiation in combination with non-ablative low-dose radiation to treat metastatic disease after progression on immunotherapy: Results of a phase II trial.
Trial report in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers.
What it found
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The trial behind it
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Who cites it
63 citing papers in PubMed, 90 citations in OpenAlex.
- A phase II randomized trial of individualized neoantigen peptide vaccine combined with unusual radiotherapy (iNATURE) in advanced solid tumors-GCOG0028.Frontiers in immunology · 2025Trial
- Unlocking the therapeutic potential of immuno-radiotherapy: insights from preclinical and clinical research.Oncoimmunology · 2026Review
- Low-dose radiotherapy as an immunomodulator in cancer: dose-specific mechanisms and hybrid high-dose/low-dose strategies.Biomarker research · 2026Review
- In Situ Vaccination, Low-Dose Targeted Radionuclide Therapy, and Immune Checkpoint Inhibition Eradicate Poorly Immunogenic Metastatic Tumors in Murine Cancer Models.Cancer immunology research · 2026Article
- Clinical evaluation of low-dose radiation therapy for immunotherapy resistance in advanced non-small cell lung cancer.Translational cancer research · 2026Article
- Dosimetric comparison of lattice radiotherapy across three modern linear accelerator platforms.Precision radiation oncology · 2026Article
- Integrated management of immunotherapy and radiotherapy for patients with metastatic non-small cell lung cancer: a narrative review of current landscape and future directions.Translational lung cancer research · 2026Review
- Low-dose radiotherapy remodels the tumor immune microenvironment via the cGAS-STING pathway: mechanisms, challenges, and combination therapy strategies.Molecular cancer · 2026Review
- Beyond local control: radiotherapy-immunotherapy combinations fromFrontiers in genetics · 2026Review
- Pushing the boundaries of radiotherapy-immunotherapy combinations: highlights from the 7Oncoimmunology · 2025Article
- Effects of incidental low-dose radiation on abscopal responses after stereotactic body radiotherapy in patients with metastatic cancer: a retrospective real-world analysis.Clinical & experimental metastasis · 2025Article
- Lattice radiation therapy for canine sinonasal carcinoma: feasibility study of spatially fractionated radiotherapy using volumetric modulated arc therapy.BMC veterinary research · 2025Article
- Low Radiation Doses to Gross Tumor Volume in Metabolism Guided Lattice Irradiation Based on Lattice-01 Study: Dosimetric Evaluation and Potential Clinical Research Implication.Journal of personalized medicine · 2025Article
- Addressing clinical needs in NSCLC immunotherapy: Mechanisms of resistance and promising combination strategies.Cell reports. Medicine · 2025Review
- Research progress of anti-angiogenic therapy combined with immunotherapy and radiotherapy for the treatment of brain metastases in non-small cell lung cancer (Review).Oncology letters · 2025Review
- Article
- Concurrent Radiation With Nivolumab and Chemotherapy for Nodal-Only Distant Metastatic Stage IV Esophageal Carcinoma.Cureus · 2025Article
- Low-dose radiotherapy enhances the efficacy of PD-L1 blockade and induces the abscopal effect.Journal for immunotherapy of cancer · 2025Article
- Article
- Bacterial membrane-modified cerium oxide nanoboosters enhance systemic antitumor effects of radiotherapy in metastatic triple-negative breast cancer.Journal of nanobiotechnology · 2025Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
33 authors at 1 institution in 3 countries.
Funding
Abstract
aimTo report early findings from a phase II trial of high-dose radiotherapy (HD-RT) with or without low-dose RT (LD-RT) for metastatic cancer.
methodsEligible patients had metastatic disease that progressed on immunotherapy within 6 months. Patients were given either HD-RT (20-70 Gy total; 3-12.5 Gy/f), or HD-RT + LD-RT (0.5-2 Gy/f up to 1-10 Gy total) to separate lesions, with continued immunotherapy. Radiographic response was assessed per RECIST 1.1 and Immune-Related Response Criteria (irRC). Primary endpoints: (1) 4-month disease control (DCR, complete/partial response [CR/PR] or stable disease [SD]) or an overall response (ORR, CR/PR) at any point in ≥10% of patients, per RECIST 1.1; (2) dose-limiting toxicity within 3 months not exceeding 30%. Secondary endpoint was lesion-specific response.
resultsSeventy-four patients (NSCLC, n = 38; melanoma n = 21) were analyzed (39 HD-RT and 35 HD-RT + LD-RT). The median follow-up time was 13.6 months. The primary endpoint was met for 72 evaluable patients, with a 4-month DCR of 42% (47% [16/34] vs. 37% [14/38] in HD-RT + LD-RT vs. HD-RT, P = 0.38), and 19% ORR at any time (26% [9/34] vs. 13% [5/38] in HD-RT + LD-RT vs. HD-RT, P = 0.27). Three patients had toxicity ≥grade 3. LD-RT lesion response (53%) was improved compared to nonirradiated lesions in HD-RT + LD-RT (23%, P = 0.002) and HD-RT (11%, P < 0.001). T- and NK cell infiltration was enhanced in lesions treated with LD-RT.
conclusionsHD-RT plus LD-RT safely improved lesion-specific response in patients with immune resistant solid tumors by promoting infiltration of effector immune cells into the tumor microenvironment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.