Safety and toxicity risks of radiotherapy combined with PD-1/PD-L1 inhibitors: A comprehensive review

IF 4.1 2区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

iScience Pub Date : 2025-06-27 DOI:10.1016/j.isci.2025.112882

Lijing Zeng , Jing Yang , Huang Xia , Zeyuan Li , Yu Lin , Qiwei Yao , Rong Zheng

引用次数: 0

Abstract

Radiotherapy (RT) combined with PD-1/PD-L1 Inhibitors has demonstrated remarkable efficacy across various cancers. However, concerns remain regarding its safety and potential toxicity. We analyze toxicity risks of RT combined with anti–PD-1/PD-L1 therapy based on current clinical studies. While a slight increase in grade 1–2 pneumonitis has been reported in patients with lung cancer, no consistent evidence suggests a rise in ≥ grade 3 pulmonary toxicity. Additionally, the combination appears well tolerated in the central nervous system, head and neck, and hepatic malignancies. This narrative review investigates key factors that may influence the risk of toxicity in combination therapy, including the dose and fractionation of RT, sequencing with immunotherapy, timing and duration of immune consolidation, and regimen heterogeneity. This review adheres to the SANRA (Scale for the Assessment of Narrative Review Articles) guidelines.

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放疗联合PD-1/PD-L1抑制剂的安全性和毒性风险：综合综述

放疗（RT）联合PD-1/PD-L1抑制剂治疗多种癌症的疗效显著。然而，对其安全性和潜在毒性的担忧仍然存在。根据目前的临床研究，我们分析了RT联合抗pd -1/PD-L1治疗的毒性风险。虽然在肺癌患者中有报道1-2级肺炎的轻微增加，但没有一致的证据表明≥3级肺毒性增加。此外，该组合在中枢神经系统、头颈部和肝脏恶性肿瘤中耐受性良好。这篇叙述性综述调查了可能影响联合治疗毒性风险的关键因素，包括RT的剂量和分级、免疫治疗的顺序、免疫巩固的时间和持续时间，以及方案的异质性。本综述遵循SANRA（叙述性综述文章评估量表）指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

iScience Multidisciplinary-Multidisciplinary

CiteScore

7.20

自引率

1.70%

发文量

1972

审稿时长

6 weeks

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