Patient characteristics and toxicity in the large tumor expansion cohort.
pneumonitis, exacerbations, uterine leiomyosarcoma, toxicity, asthma
PNEUMONITIS, METASTASIS, UTERINE LEIOMYOSARCOMA, TYPE 2 RESPIRATORY FAILURE, LUNG METASTASES, ASTHMA, METASTASES
Since the original publication, 41 additional patients with at least 1 large (more than 65 cc) metastasis were enrolled into an expansion cohort with SBRT administered to 117 metastases. Baseline characteristics are listed in Among those available for analysis, there was only 1 dose-limiting toxicity (DLT) in the expansion cohort, grade 3 pneumonitis, which occurred in a patient with uterine leiomyosarcoma who received 3 cycles of pembrolizumab and SBRT to 3 central lung metastases. The patient had a past medical history of asthma with exacerbations requiring steroids in the prior 4 months, was a former smoker, had no prior radiation, and previously received 3 lines of systemic therapy (no immunotherapy). The patient demonstrated a mixed response to SBRT+P and was admitted to the intensive care unit for type 2 respiratory failure approximately 6 weeks after completion of SBRT and 1 week after her third cycle of pembrolizumab. All lung dose constraints per protocol were met.