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@ARTICLE{Ozair:301321,
author = {M. Z. Ozair and B. Halmos and A. D'Aiello and J. Yun and A.
R. Filippi and A. Rimner$^*$ and S. H. Lin and C. B. Simone
and N. Ohri},
title = {{C}hemotherapy-{F}ree {T}reatment with {R}adiotherapy and
{I}mmunotherapy for {L}ocally {A}dvanced {N}on-{S}mall
{C}ell {L}ung {C}ancer.},
journal = {Cancers},
volume = {17},
number = {9},
issn = {2072-6694},
address = {Basel},
publisher = {MDPI},
reportid = {DKFZ-2025-00993},
pages = {1524},
year = {2025},
abstract = {Background: Concurrent chemoradiotherapy (CRT) followed by
immunotherapy is a standard treatment for locally advanced
non-small cell lung cancer (LA-NSCLC), yet many patients are
ineligible due to treatment-related toxicity or poor
functional status. Chemotherapy-free approaches using
radiotherapy (RT) and immunotherapy may offer a safer and
equally effective alternative in select patient populations.
Methods: A comprehensive literature review was conducted
using PubMed, Google Scholar, and relevant conference
proceedings focusing on trials between 2000 and 2024.
Studies investigating chemotherapy-free regimens combining
RT and immunotherapy in LA-NSCLC were analyzed, with
emphasis on clinical outcomes, biomarker use, treatment
sequencing, radiation dose/fractionation, and safety.
Results: Multiple Phase I/II trials reported promising
efficacy with one-year progression-free survival (PFS)
ranging from $39\%$ to $76\%.$ Toxicity was generally
acceptable, though higher-grade adverse events were more
frequent in older, frail populations. Trials integrating
PD-L1 expression, tumor mutational burden (TMB), and
circulating tumor DNA (ctDNA) showed potential for improved
patient stratification. Variation in immunotherapy timing
(induction, concurrent, or consolidation) and radiation
schedules highlight the need for optimization. Conclusions:
Chemotherapy-free regimens represent a promising treatment
strategy for patients with LA-NSCLC, especially those that
are ineligible for standard CRT. Biomarker-driven patient
selection and the rational integration of RT and
immunotherapy are critical to improving outcomes. Randomized
trials are warranted to establish the efficacy and safety of
these emerging approaches.},
subtyp = {Review Article},
keywords = {LA-NSCLC (Other) / chemotherapy-free (Other) /
immunotherapy (Other) / radiation therapy (Other)},
cin = {FR01},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40361451},
doi = {10.3390/cancers17091524},
url = {https://inrepo02.dkfz.de/record/301321},
}