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@ARTICLE{Acker:298423,
      author       = {F. Acker and M. Reck and D. Martin$^*$ and S. Rieken and S.
                      Heinzen and M. Rost and L. Aguinarte and H. Schulte and H.
                      Serve and T. Oellerich and M. Sebastian and F. C. Althoff},
      title        = {{E}fficacy and safety of immune checkpoint inhibition
                      combined with concurrent chemoradiotherapy in patients with
                      stage {III} unresectable non-small cell lung cancer: {A}
                      systematic review and meta-analysis.},
      journal      = {European journal of cancer},
      volume       = {218},
      issn         = {0959-8049},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-00279},
      pages        = {115266},
      year         = {2025},
      abstract     = {In patients with unresectable, stage III non-small cell
                      lung cancer (NSCLC), durvalumab maintenance after concurrent
                      chemoradiotherapy (cCRT) was shown to improve survival over
                      placebo. As subgroup analyses indicated better outcomes with
                      earlier start of durvalumab, several trials evaluated
                      concomitant checkpoint inhibition (CPI) with cCRT. However,
                      this may introduce an increased risk of treatment-related
                      pulmonary toxicity.We conducted a systematic review and
                      meta-analysis of clinical trials of combined cCRT plus CPI
                      followed by CPI maintenance in patients with stage III
                      NSCLC. Endpoints included incidence of pneumonitis by any
                      cause, objective response rate (ORR), progression-free
                      (PFS), and overall survival (OS).A total of 7 trials
                      comprising 653 patients were included. In trials of
                      single-agent CPI with cCRT, pneumonitis occurred in 33 $\%$
                      of patients (95 $\%$ confidence interval [CI], 28-39) with 7
                      $\%$ (5-9) having CTCAE grade 3-5. In one trial, double CPI
                      (PD-1 and CTLA4) plus cCRT was associated with excessive
                      pneumonitis-related mortality of 16 $\%$ (4-40). Across all
                      trials, ORR was 69 $\%$ (63-76). Median PFS and OS were 16.3
                      (95 $\%$ CI, 14.0-20.5) and 39.5 months (35.3-45.9),
                      respectively. Three-year PFS and OS were 36.8 $\%$ (95 $\%$
                      CI, 32.7-41.4) and 53.1 $\%$ (49.1-57.4). Sensitivity
                      analysis showed that induction chemoimmunotherapy prior cCRT
                      plus CPI was associated with improved PFS of 48.0 $\%$ at 3
                      years (95 $\%$ CI, 40.7-56.7) in one trial.Addition of
                      single-agent CPI to cCRT is manageable in selected patients
                      with stage III NSCLC. Efficacy outcomes appear to be in line
                      with previous data of cCRT followed by CPI maintenance.},
      subtyp        = {Review Article},
      keywords     = {Checkpoint inhibitor (Other) / Chemoradiotherapy (Other) /
                      Locally advanced (Other) / Meta-analysis (Other) / NSCLC
                      (Other) / Stage III (Other) / Systematic review (Other)},
      cin          = {FM01},
      ddc          = {610},
      cid          = {I:(DE-He78)FM01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39893747},
      doi          = {10.1016/j.ejca.2025.115266},
      url          = {https://inrepo02.dkfz.de/record/298423},
}