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June 22, 2017. Ever wonder about the interaction of radiation with immunotherapies, for better or worse? Take a look at this secondary analysis published last month in Lancet. Advanced and/or metastatic non-small cell lung cancer (NSCLC) patients treated at UCLA and enrolled in the Phase I KEYNOTE-001 trial (n=98) on safety of pembrolizumab were assessed post-hoc to detect any additional benefit or risk with previous radiation therapy (RT). Significant differences were found in survival outcomes with (n=42) vs without (n=56) previous RT: progression-free survival of 4.4 vs 2.1 months, respectively, and overall survival of 10.7 vs 5.3 months. And that is with all brain met patients (n=8) in the previous RT cohort. Looking only at patients with previous extracranial RT, the outcomes are even better. Overall, Grade ≥3 pembro-related lung toxicity occurred in one patient with previous RT and one patient without RT. This is a big win for establishing the safety and promising efficacy pembro following RT for NSCLC.