J Immunother Cancer: The efficacy and safety of the treatment of relapsed small± cell lung cancer with stereotactic body radiotherapy

Immune checkpoint blocking (ICB) for the treatment of relapsed small cell lung cancer (SCLC) of targeting programmed cell death protein 1 and cytotoxic T lymphocyte-related protein 4 has achieved some clinical efficacy.
study was designed to assess the efficacy of ICC Plus or Without Stereotacing Body Radiotherapy (SBRT) for the treatment of relapsed SCLC.
patients with relapsed SCLC who had previously treated no more than 2 lines were randomly assigned to Group A: Durvalumab (D) 1500/Tremlimumab, T) 75 mg (intravenous injection every 4 weeks, no SBRT); Group B: Select a tumor site for immunosensitive SBRT (9Gy×3 times), followed by D/T treatment until the disease progresses or reaches 12 months.
end points are the overall response rate (ORR) and the progress-free survival rate (PFS).
, circulating lymphocyte spectrum in multiple collected exospositive blood samples and tumor-infused lymphocytes (TIL) in therapeutic biopsies were evaluated as pharmacodynamic markers.
18 patients were randomly divided into two groups (9 each): the middle age was 70 years, of which 41.2% were women.
PFS and ORR in Group A were 2.1 months and 0%, respectively, and Group B were 3.3 months and 28.6%, respectively.
survival of Groups A and B was 2.8 months and 5.7 months, respectively.
of the 15 solid tumor efficacy evaluation criteria (RECIST), the combined efficacy of D/T±SBRT was: partial remission rate of 13.3%, stabilization period 26.6%, progression period 60.0%, total medium PFS and OS 2.76 and 3.9 months, respectively.
most common adverse reactions in Group A were level 1 fatigue (66%) and level 1 amylase elevation (56%), and group B was level 1 fatigue (56%) and pain (44%).
cd8 (-) ICOS-T cells were significantly increased in exo-weekly blood after treatment, infant T-cells were significantly reduced (p-0.0454), and the active CD8-ICOS-T cell count in the respondent TIL was significantly increased.
, D/T combined SBRT or not to treat relapsed SCLC is safe, but does not show enough signs of efficacy.
and TIL changes were consistent with the immune response.