href="#ulink_37886cbe-01e8-58d9-b7d5-49bb9b86ea21">95]. Preclinical data and available case reports also suggest a superiority of simultaneous regimens or irradiation after the start of immune checkpoint inhibition over a schedule starting with irradiation [63, 69, 96]. The data on the introduction of immunotherapy into normofractionated regimens encompassing adjuvant lymphatic regions applied in neoadjuvant or adjuvant settings and for primary radio(-chemo) therapy is scarce. In addition, the optimal radiation dose, fractionation, and scheduling might differ depending on the immunotherapeutic strategy investigated.
Conclusion
Immunotherapy is being established as a “fourth pillar” of cancer therapy and is entering the clinic in multiple tumour entities. There is a strong theoretical and preclinical rationale for different immunotherapy strategies stating that the combination of immunotherapy with radiation might be beneficial (Fig. 1). Multiple combination strategies have entered clinical trials (Table 1). However, the details of optimal combination regimens are still under investigation.
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