A rad investigation.

We know radiation is not always safe concurrent with immune checkpoint inhibition (ICI). At the same time, Big Pharma has seen no reason to  prioritize establishing the safety of radiation during or around the time of ICI in landmark trials gaining their respective FDA approvals. This ingenious investigation found a practical workaround: it used an FDA database comprising 68 prospective trials submitted in initial or supplemental licensing applications for ICI, which typically includes receipt of non-protocol cancer therapies (e.g. radiation!). Across 16,835 trial enrollees, those receiving radiation (n=1733) within 90 days prior to ICI had a 1.2% absolute increase in adverses events, mainly fatigue, with no increase in grade 3+ events. In other words, in general, there are currently no signs for concern, though prospective trials formally including radiation would be nice. | Anscher, JAMA Oncol 2021