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Low-dose intestinal irradiation enhances the efficacy and prognosis of PD-1 blockade in metastatic non-small cell lung cancer - PubMed

6 hours ago
  • #immunotherapy
  • #non-small cell lung cancer
  • #gut microbiota
  • Low-dose intestinal irradiation (ILDR) enhances PD-1 blockade efficacy in metastatic non-small cell lung cancer (mNSCLC).
  • Optimal efficacy observed with small intestinal mean radiation dose (SIMRD) of 1-3 Gy, leading to longer progression-free survival (PFS) and overall survival (OS).
  • Higher (>3 Gy) or lower (<1 Gy) SIMRD independently predicted worse OS.
  • Prospective results confirmed best disease control rate and PFS with SIMRD of 1-3 Gy.
  • Responders showed enrichment in Bacillota, Clostridia, and indole derivatives like indole-3-carboxylic acid.
  • 1-3 Gy group exhibited increased macrophage inflammatory protein-3α and reduced α4β7+ regulatory T cells.
  • ILDR likely modulates the gut microbiota-metabolite-immune axis to enhance PD-1 blockade efficacy.