ReviewCell communication and signaling : CCS2023
Radiation combined with immune checkpoint inhibitors for unresectable locally advanced non-small cell lung cancer: synergistic mechanisms, current state, challenges, and orientations.
Review in Cell communication and signaling : CCS, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Neoadjuvant immunotherapy for NSCLC: superior combination strategies, optimal treatment cycles, and predictive indicators from a Bayesian meta-analysis.Frontiers in immunology · 2025Pooled it
- Pooled it
- Nivolumab plus chemoradiotherapy followed by nivolumab with or without ipilimumab for untreated locally advanced stage III NSCLC: a randomized phase 3 trial.Nature cancer · 2026Trial
- Radiotherapy-induced abscopal effects in immune checkpoint inhibitor-refractory metastatic disease: results from a large multicenter real-world cohort study.Oncoimmunology · 2026Article
- Global hotspots and trends of stereotactic radiotherapy for pancreatic cancer: a bibliometric analysis and visual analysis from 2015 to 2025.Translational cancer research · 2026Article
- Regulatory role of IL-17-mediated inflammatory pathways in lung cancer initiation and progression.Discover oncology · 2026Review
- Role of Cytokines in Oligometastatic Non-Small-Cell Lung Cancer Treated with Stereotactic Radiation Therapy: An Observational Pilot Study.Biomolecules · 2026Observational
- Advances in neoadjuvant immunotherapy for non-small cell lung cancer.Frontiers in immunology · 2026Review
- Clinical outcomes of intrathecal anti-PD-1 therapy with or without whole-brain radiotherapy in melanoma leptomeningeal metastasis: a multicenter retrospective study.Frontiers in immunology · 2026Article
- Efficacy and safety analysis of induction therapy for unresectable locally advanced non-small-cell lung cancer: a retrospective study based on IPTW.Frontiers in oncology · 2026Article
- From local control to immune modulation: hypofractionated radiotherapy as a backbone for cancer immunotherapy.Frontiers in oncology · 2026Review
- Multi-omics biomarkers for predicting resistance, hyperprogression, and immune-related toxicity during PD-1/PD-L1 therapy in lung cancer: a literature review.Frontiers in immunology · 2026Review
- Preliminary exploration of the optimal timing of chemoimmunotherapy combined with radiotherapy for oligometastatic esophageal squamous cell carcinoma and analysis of prognostic factors: a multicenter retrospective study.Frontiers in oncology · 2026Article
- Bioinformatics analysis of DLGAP5 as a biomarker in lung adenocarcinoma: implications for immune infiltration and targeted therapy.Discover oncology · 2025Article
- Chemoradioimmunotherapy versus chemoimmunotherapy or chemoradiotherapy in extensive-stage small-cell lung cancer: A retrospective analysis of survival outcomes.Precision radiation oncology · 2025Article
- [Combination of Radiotherapy and Immunotherapy for Unresectable Stage III Non-small Cell Lung Cancer: Clinical Progress Advances and Future Directions].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2025Review
- A New Era, New Risks: The Cardio-Oncology Perspective on Immunotherapy in Non-Small Cell Lung Cancer.Cancers · 2025Review
- Article
- Chemotherapy-Free Treatment with Radiotherapy and Immunotherapy for Locally Advanced Non-Small Cell Lung Cancer.Cancers · 2025Review
- Integration of Circulating Tumor DNA and Metabolic Parameters onAdvanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Until the advent of immune checkpoint inhibitors (ICIs), definitive radiotherapy (RT) concurrently with chemotherapy was recommended for unresectable, locally advanced non-small cell lung cancer (LA-NSCLC). The trimodality paradigm with consolidation ICIs following definitive concurrent chemoradiotherapy has been the standard of care since the PACIFIC trial. Preclinical evidence has demonstrated the role of RT in the cancer-immune cycle and the synergistic effect of RT combined with ICIs (iRT). However, RT exerts a double-edged effect on immunity and the combination strategy still could be optimized in many areas. In the context of LA-NSCLC, optimized RT modality, choice, timing, and duration of ICIs, care for oncogenic addicted tumors, patient selection, and novel combination strategies require further investigation. Targeting these blind spots, novel approaches are being investigated to cross the borders of PACIFIC. We discussed the development history of iRT and summarized the updated rationale for the synergistic effect. We then summarized the available research data on the efficacy and toxicity of iRT in LA-NSCLC for cross-trial comparisons to eliminate barriers. Progression during and after ICIs consolidation therapy has been regarded as a distinct resistance scenario from primary or secondary resistance to ICIs, the subsequent management of which has also been discussed. Finally, based on unmet needs, we probed into the challenges, strategies, and auspicious orientations to optimize iRT in LA-NSCLC. In this review, we focus on the underlying mechanisms and recent advances of iRT with an emphasis on future challenges and directions that warrant further investigation. Taken together, iRT is a proven and potential strategy in LA-NSCLC, with multiple promising approaches to further improve the efficacy. Video Abstract.
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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.