Current and Future Perspectives of Combining Chemotherapy and Stereotactic Body Radiation Therapy with Immunotherapy in the Treatment of Lung Cancer

Lung cancer is a huge public health concern all over the world, including India, and for many years, the gold standard treatment has been the meticulous use of surgery, chemotherapy, and radiotherapy. Recent advances in the use of stereotactic body radiation therapy (SBRT) and immunotherapy have shifted the focus of lung cancer treatment away from conventional treatments and towards the use of immunotherapy in combination. Despite the fact that antibodies targeting the programmed death-1/programmed death ligand 1 (PD-1/PD-L1) checkpoint have been at the forefront of immuno-oncology, efforts to eliminate cancer by exploiting the host immune system using adoptive cell therapy (TCR, CAR T, TIL) have also been made. Recently, a combination of radiotherapy and immunotherapy techniques in lung cancer patients was evaluated, with the goal of generating both direct and indirect DNA damages in cancer cells, resulting in local control of target lesions. As a result, the number of clinical trials studying the association between the combined effects of immunotherapy and radiation therapy has increased. The current review compiles and presents clinical evidence supporting the use of immunotherapy and SBRT in combination across all stages of lung cancer, with an emphasis on both treatment response and mechanism of action. In addition, particular emphasis is placed on preventing an overview of active clinical trials investigating the combination of conventional chemotherapy with SBRT and immunotherapy in the treatment of lung cancer.