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    Multi-institutional report on toxicities of concurrent nivolumab and radiation therapy

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    Author
    Amin, N.P.
    Zainib, M.
    Parker, S.M.
    Date
    2018
    Journal
    Advances in Radiation Oncology
    Publisher
    Elsevier Inc
    Type
    Article
    
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    See at
    https://dx.doi.org/10.1016/j.adro.2018.04.015
    Abstract
    Purpose: Radiation therapy (RT) and nivolumab are standard therapies for a wide range of advanced and metastatic cancers, yet little is known about the toxicity profile of their combined treatment. The rate of grade ≥3 toxicities from nivolumab monotherapy and radiation-only palliative treatments has been reported at 10% to 18% and 0% to 26%, respectively. We reviewed our experience to assess the acute toxicity profile of concurrent RT-nivolumab. Methods and materials: A retrospective review of all consecutive patients from January 2015 to May 2017 who received concurrent RT-nivolumab was conducted at 4 separate centers. Concurrent RT-nivolumab was defined as RT completed between 3 days prior to initial nivolumab infusion and 28 days after the last nivolumab infusion. Results: Of the 261 patients who received nivolumab, 46 (17.6%) had concurrent RT to 67 treatment sites. The median follow-up was 3.3 months (interquartile range, 1.7-6.1 months) and the 1-year overall survival rate was 22%. For the 11 of 46 patients (24%) who were alive at last analysis, the median follow-up was 12.8 months (interquartile range, 8.3-14.9 months). The most common histology, RT prescription, and treatment site were non-small cell lung cancer (23 of 46 patients; 50%), 30 Gy in 10 fractions (24 of 67 patients; 35.8%), and abdomen/pelvis (16 of 67 patients; 24%), respectively. Four patients with melanoma had concurrent ipilimumab and were removed from the final toxicity analysis of RT-nivolumab. Within 3 months of treatment with RT-nivolumab, 4 of 42 patients (9.5%) experienced grade 3 toxicity and 2 of these patients' toxicities were attributed specifically to the addition of RT: grade 3 hearing loss after whole brain RT and grade 3 pancreatitis after stereotactic body RT to the left adrenal gland. One death from transaminitis was attributed to nivolumab alone because the RT field did not encompass the liver. Conclusions: Concurrent RT-nivolumab did not appear to increase the toxicity profile from the previously reported toxicity rates from nivolumab or radiation alone. Copyright 2018 The Authors
    Keyword
    toxicity
    Cancer--Treatment
    Radiotherapy
    Nivolumab
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049733172&doi=10.1016%2fj.adro.2018.04.015&partnerID=40&md5=32cf1238486ef69be02a7b1ad4a60a4c; http://hdl.handle.net/10713/9071
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.adro.2018.04.015
    Scopus Count
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    UMB Open Access Articles 2018

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