Table 1.
Patient characteristics and treatments.
| Characteristic | Total # of patients (%) (n = 59) |
|---|---|
| Sex | |
| Male | 38 (64%) |
| Female | 21 (36%) |
| Primary diagnoses | |
| Renal cell carcinoma | 27 (46%) |
| Melanoma | 18 (31%) |
| Non-small cell lung cancer | 5 (9%) |
| Bladder carcinoma | 7 (12%) |
| Pancreas adenocarcinoma | 1 (1%) |
| Head and neck squamous cell carcinoma | 1 (1%) |
| Prior treatments for primary tumor | |
| Oncologic surgery | 44 (75%) |
| Chemotherapy | 16 (27%) |
| Targeted therapy | 37 (63%) |
| Immune therapy | 6 (10%) |
| Brain metastasis | |
| Yes | 21 (36%) |
| s/p surgical resection | 8 |
| s/p SRS | 17 |
| s/p WBRT | 7 |
| Observation | 1 |
| No | 38 (64%) |
| Metastasis status prior to treatment | |
| Widely metastatic | 45 (76%) |
| Oligo-metastatica | 13 (22%) |
| Non-metastatic | 1 (2%) |
| ECOG PS at the initiation of ICI | |
| 0 | 19 (32%) |
| 1 | 31 (53%) |
| 2 | 5 (8%) |
| ≥3 | 0 (0%) |
| Unavailable | 4 (7%) |
| ICI type (single vs. multiple) | |
| Nivolumab aloneb | 27 (46%) |
| Ipilimumab alone | 4 (7%) |
| Pembrolizumab alone | 4 (7%) |
| Atezolumab alone | 5 (8%) |
| >1 ICIc | 19 (32%) |
| Any simultaneous combination of ICIs | 14 (24%) |
| Median duration of ICI treatment, in months | |
| All patients | 5 |
| Single agent | 4 |
| >1 ICI | 7.5 |
| ICI status | |
| Ongoing treatment at last follow-up | 22 (37%) |
| Stopped d/t progressive disease | 24 (41%) |
| Stopped d/t toxicity | 6 (10%) |
| Stopped d/t patient's death | 5 (8%) |
| Stopped d/t hospice enrollment | 1 (2%) |
| Stopped because patient finished planned course | 1 (2%) |
|
Radiation Characteristic |
# of treatments (%) |
| Total # of concurrent radiation courses | 137 |
| # of RT courses before ICI | 35 (26%) |
| # of RT courses simultaneous with ICI | 77 (56%) |
| # of RT courses after ICI | 25 (18%) |
| Treatment sites (out of 137 courses)d | |
| Pelvis | 24 |
| Head/neck including brain | 36 |
| Cervical spine | 4 |
| Thoracic spine | 10 |
| Lumbar spine | 8 |
| Chest wall | 13 |
| Lungs/mediastinum | 21 |
| Extremities | 12 |
| Abdomen | 14 |
| Treatment technique | |
| SAbR | 77 (56%) |
| 3D-CRT or IMRT | 22 (16%) |
| Conventional 3D | 17 (12.5%) |
| SRS | 17 (12.5%) |
| Superficial | 4 (3%) |
| Number of patients with: | |
| At least one hypofractionated RT (excluding SRS) | 59 (100%) |
| At least one SAbR | 49 (83%) |
| C-RT (3D-CRT or IMRT) but not SAbR | 10 (17%) |
| Did patient receive concurrent RT courses other than hypofractionated body RT | |
| Yese | 21 (36%) |
| No | 38 (64%) |
| Fractionation schemesf | |
| SAbR or C-RT | |
| Median dose in Gy (range) | 30 (6-54) |
| Median fraction # (range) | 3 (1-5) |
| Mean target volume (cc) | 141 |
| Other concurrent RT (non-SRS) | |
| Median dose (range) | 30 (15–60) |
| Median fraction # (range) | 10 (5–20) |
| SRSg | |
| Median dose (range) | 24 (13–40) |
| Median fraction # (range) | 1 (1–5) |
| Did patient receive other non-concurrent RT courses beyond above time limits? | |
| Yes | 34 (58%) |
| No | 25 (42%) |
Abbreviations: #, number; %, percentage; yrs, years; ICI, immune checkpoint inhibitor; s/p, status post; SRS, stereotactic radiosurgery; WBRT, whole-brain radiotherapy; ECOG PS, Eastern Cooperative Oncology Group performance status; d/t, due to; RT, radiotherapy; SAbR, stereotactic ablative radiotherapy; 3D-CRT, 3-dimensional conformal radiotherapy; IMRT, intensity modulated radiotherapy; C-RT, hypofractionated conformal radiotherapy; Gy, Gray; cc, cubic centimeters.
Oligometastatic was defined as ≤5 lesions at the time of initiation of therapy.
One Nivolumab alone patient received simultaneous Cabozantinib.
This included patients who received sequential or simultaneous ICIs.
Some treatments overlap sites.
This included conventional RT or SRS.
This included all radiation treatments during or ± 8 weeks from ICI start.
Two patients received hypofractionated CyberKnife to 40 Gy in 5 fractions.