{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:20:39Z","timestamp":1766726439941,"version":"3.48.0"},"reference-count":61,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Soonchunhyang University Research Fund"},{"DOI":"10.13039\/501100008003","name":"Korea Institute of Radiological and Medical Sciences","doi-asserted-by":"crossref","award":["50552-2025"],"award-info":[{"award-number":["50552-2025"]}],"id":[{"id":"10.13039\/501100008003","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Purpose: The objective of this study was to evaluate the synergistic effect of combining an immune checkpoint inhibitor (ICI) with radiotherapy (RT) on murine fibrosarcoma and to conduct a narrative review of clinical studies on soft tissue sarcoma (STS). Materials and Methods: Forty male C3H mice (aged 5 weeks) were injected intramuscularly with 2 \u00d7 105 FSaII cells into the right thigh and randomly assigned to four groups: (1) control; (2) RT; (3) InVivoMab\u2122 (CD279) (mouse anti-PD-1 antibody) (ICI group); and (4) combined treatment with InVivoMab\u2122 (CD279) and RT (combination group). On day \u22121, ICI was administered intraperitoneally. On day 0, RT (10 Gy, single fraction) was delivered locally to the tumors in the right hind limb. Subsequently, ICI was injected twice weekly (a total of 8 times). On day 26, all mice were euthanized, and the results were analyzed. In addition, a narrative review was conducted to identify clinical evidence. Results: On day 26, mean gross tumor volumes were 3578.13 \u00b1 407.32 mm3 in the control group, 1995.72 \u00b1 970.46 mm3 in the RT group, 2729.96 \u00b1 286.47 mm3 in the ICI group, and 1007.92 \u00b1 197.36 mm3 in the combination group. Gross tumor growth delay was most pronounced in the combination group. Moreover, the TUNEL assay demonstrated a significant increase in apoptosis in the combination group. Analysis of the underlying immune system revealed significantly higher expression of CD4+, CD8+, and IFN-\u03b3 in the combination group. The literature search identified only 12 case reports and 3 prospective studies involving patients with STS treated with the combined treatment of ICI and RT, suggesting potential synergism with acceptable toxicity. Conclusions: The current study demonstrated a synergistic effect of combining an ICI with RT in murine fibrosarcoma. There was limited data in the clinical setting. Further investigations are warranted to determine the optimal combination strategy of ICI and RT for STS.<\/jats:p>","DOI":"10.3390\/cimb48010020","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T16:41:19Z","timestamp":1766594479000},"page":"20","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiotherapy Combined with Immune Checkpoint Inhibitor on Murine Fibrosarcoma and a Narrative Review of Clinical Studies"],"prefix":"10.3390","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6935-2149","authenticated-orcid":false,"given":"Wonwoo","family":"Kim","sequence":"first","affiliation":[{"name":"AI Institute for Drug Discovery, Korea Pharmaceutical and Bio-Pharma Manufacturers Association, Seoul 06666, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7255-2232","authenticated-orcid":false,"given":"Hyunkyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5279-3087","authenticated-orcid":false,"given":"Won Il","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi Sook","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0637-4110","authenticated-orcid":false,"given":"Sun Hyun","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Soonchunhyang University College of Medicine, Bucheon 14584, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.suc.2016.05.005","article-title":"Epidemiology and Etiology of Sarcomas","volume":"96","author":"Hui","year":"2016","journal-title":"Surg. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"70","DOI":"10.32074\/1591-951X-213","article-title":"The 2020 Who Classification of Soft Tissue Tumours: News and Perspectives","volume":"113","author":"Sbaraglia","year":"2021","journal-title":"Pathologica"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.soc.2022.07.010","article-title":"Evidence for the Current Management of Soft-Tissue Sarcoma and Gastrointestinal Stromal Tumors and Emerging Directions","volume":"32","author":"Dossa","year":"2023","journal-title":"Surg. Oncol. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1200\/JCO.1998.16.1.197","article-title":"Randomized Prospective Study of the Benefit of Adjuvant Radiation Therapy in the Treatment of Soft Tissue Sarcomas of the Extremity","volume":"16","author":"Yang","year":"1998","journal-title":"J. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2484","DOI":"10.1245\/s10434-014-3732-4","article-title":"Efficacy of Adjuvant Radiation Therapy in the Treatment of Soft Tissue Sarcoma of the Extremity: 20-Year Follow-up of a Randomized Prospective Trial","volume":"21","author":"Beane","year":"2014","journal-title":"Ann. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1016\/S0140-6736(02)09292-9","article-title":"Preoperative Versus Postoperative Radiotherapy in Soft-Tissue Sarcoma of the Limbs: A Randomised Trial","volume":"359","author":"Davis","year":"2002","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.ijrobp.2009.09.042","article-title":"American Society for Therapeutic Radiology and Oncology (Astro) and American College of Radiology (Acr) Practice Guideline for the Performance of Stereotactic Body Radiation Therapy","volume":"76","author":"Potters","year":"2010","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Shah, N.K., Yegya-Raman, N., Jones, J.A., and Shabason, J.E. (2021). Radiation Therapy in Metastatic Soft Tissue Sarcoma: From Palliation to Ablation. Cancers, 13.","DOI":"10.3390\/cancers13194775"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"108619","DOI":"10.1016\/j.ejso.2024.108619","article-title":"Unraveling the Role of Local Ablative Therapies for Patients with Metastatic Soft Tissue Sarcoma\u2014A Retrospective Multicenter Study of the Bavarian University Hospitals","volume":"50","author":"Grube","year":"2024","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/S1470-2045(17)30622-8","article-title":"Gemcitabine and Docetaxel Versus Doxorubicin as First-Line Treatment in Previously Untreated Advanced Unresectable or Metastatic Soft-Tissue Sarcomas (Geddis): A Randomised Controlled Phase 3 Trial","volume":"18","author":"Seddon","year":"2017","journal-title":"Lancet Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Dalal, S., Shan, K.S., Thaw Dar, N.N., Hussein, A., and Ergle, A. (2024). Role of Immunotherapy in Sarcomas. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25021266"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Knoedler, L., Huelsboemer, L., Hollmann, K., Alfertshofer, M., Herfeld, K., Hosseini, H., Boroumand, S., Stoegner, V.A., Safi, A.F., and Perl, M. (2024). From Standard Therapies to Monoclonal Antibodies and Immune Checkpoint Inhibitors\u2014An Update for Reconstructive Surgeons on Common Oncological Cases. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1276306"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3887","DOI":"10.1002\/j.1460-2075.1992.tb05481.x","article-title":"Induced Expression of Pd-1, a Novel Member of the Immunoglobulin Gene Superfamily, Upon Programmed Cell Death","volume":"11","author":"Ishida","year":"1992","journal-title":"EMBO J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1182\/blood-2008-12-195792","article-title":"Tumor Antigen-Specific Cd8 T Cells Infiltrating the Tumor Express High Levels of Pd-1 and Are Functionally Impaired","volume":"114","author":"Ahmadzadeh","year":"2009","journal-title":"Blood"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"16824","DOI":"10.1002\/jcp.28358","article-title":"Pd-1\/Pd-L1 Pathway: Basic Biology and Role in Cancer Immunotherapy","volume":"234","author":"Salmaninejad","year":"2019","journal-title":"J. Cell. Physiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s00251-017-1015-5","article-title":"Pd-1 and Cancer: Molecular Mechanisms and Polymorphisms","volume":"70","author":"Salmaninejad","year":"2018","journal-title":"Immunogenetics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/PPO.0000000000000061","article-title":"Inducible Expression of B7-H1 (Pd-L1) and Its Selective Role in Tumor Site Immune Modulation","volume":"20","author":"Sanmamed","year":"2014","journal-title":"Cancer J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/ni1443","article-title":"The Function of Programmed Cell Death 1 and Its Ligands in Regulating Autoimmunity and Infection","volume":"8","author":"Sharpe","year":"2007","journal-title":"Nat. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.molmed.2014.10.009","article-title":"Human Cancer Immunotherapy with Antibodies to the Pd-1 and Pd-L1 Pathway","volume":"21","author":"Ohaegbulam","year":"2015","journal-title":"Trends Mol. Med."},{"key":"ref_20","first-page":"727","article-title":"Pd-1\/Pd-L1 Pathway: Current Researches in Cancer","volume":"10","author":"Han","year":"2020","journal-title":"Am. J. Cancer. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Huang, H., Fan, Y., Zhang, S., Bai, X., Wang, X., and Shan, F. (2025). Emerging Immunotherapy and Tumor Microenvironment for Advanced Sarcoma: A Comprehensive Review. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1507870"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1089\/ars.2013.5668","article-title":"Ionizing Radiation-Induced DNA Damage, Response, and Repair","volume":"21","author":"Santivasi","year":"2014","journal-title":"Antioxid. Redox Signal."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e498","DOI":"10.1016\/S1470-2045(15)00007-8","article-title":"Radiation and Checkpoint Blockade Immunotherapy: Radiosensitisation and Potential Mechanisms of Synergy","volume":"16","author":"Sharabi","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.semradonc.2024.01.001","article-title":"Radiotherapy Combined with Intralesional Immunostimulatory Agents for Soft Tissue Sarcomas","volume":"34","author":"Su","year":"2024","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e352","DOI":"10.1016\/S1470-2045(24)00075-5","article-title":"Radiotherapy, Immunity, and Immune Checkpoint Inhibitors","volume":"25","author":"Lynch","year":"2024","journal-title":"Lancet Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Wang, X., Wang, Y., Zhang, Y., Shi, H., Liu, K., Wang, F., Wang, Y., Chen, H., Shi, Y., and Wang, R. (2024). Immune Modulatory Roles of Radioimmunotherapy: Biological Principles and Clinical Prospects. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1357101"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100867","DOI":"10.1016\/j.neo.2022.100867","article-title":"Synergizing Radiotherapy and Immunotherapy: Current Challenges and Strategies for Optimization","volume":"36","author":"Pitroda","year":"2023","journal-title":"Neoplasia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1002\/1097-0142(197702)39:2+<737::AID-CNCR2820390708>3.0.CO;2-M","article-title":"The Effects of Therapeutic Irradiation on Lymphocytes and Immunity","volume":"39","author":"Order","year":"1977","journal-title":"Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1001\/jamaoncol.2024.1527","article-title":"Radiation with Immunotherapy May Be a Double-Edged Sword-How Can We Learn from Recent Negative Clinical Trials?","volume":"10","author":"McGee","year":"2024","journal-title":"JAMA Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"286","DOI":"10.17998\/jlc.2024.06.26","article-title":"Recent Update of Proton Beam Therapy for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis","volume":"24","author":"Bae","year":"2024","journal-title":"J. Liver Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Yu, S., Wang, Y., He, P., Shao, B., Liu, F., Xiang, Z., Yang, T., Zeng, Y., He, T., and Ma, J. (2022). Effective Combinations of Immunotherapy and Radiotherapy for Cancer Treatment. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.809304"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.ijrobp.2015.05.016","article-title":"Indirect Tumor Cell Death after High-Dose Hypofractionated Irradiation: Implications for Stereotactic Body Radiation Therapy and Stereotactic Radiation Surgery","volume":"93","author":"Song","year":"2015","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"20363613241290788","DOI":"10.1177\/20363613241290788","article-title":"The Efficacy of Combination Immunotherapy with Ipilimumab Plus Nivolumab in Metastatic Myxofibrosarcoma","volume":"16","author":"Kalofonou","year":"2024","journal-title":"Rare Tumors"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"136","DOI":"10.14740\/jmc4237","article-title":"Long Duration Pembrolizumab for Metastatic Undifferentiated Pleomorphic Soft Tissue Sarcoma with Multimodality Therapy","volume":"15","author":"Reuben","year":"2024","journal-title":"J. Med. Cases"},{"key":"ref_35","first-page":"e44990","article-title":"Salvage Radiosurgery for Recurrent Cardiac Sarcoma: A Case Report","volume":"15","author":"Shah","year":"2023","journal-title":"Cureus"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Jeon, W.J., Moon, J.H., Pham, B., Joung, B., Denham, L., and Brothers, J. (2023). Case Report: An Exceptional Response to Neoadjuvant Radiotherapy and Chemotherapy in Undifferentiated Pleomorphic Sarcoma Following Checkpoint Inhibitor Use. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.1198292"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.21037\/tlcr-22-572","article-title":"Locally Advanced Undifferentiated Small Round Cell Sarcoma of the Lung with Novel Sdccag8-Akt3 Fusion and Type Ii Tumor Immunity in the Microenvironment: A Rare Case Report","volume":"11","author":"Huang","year":"2022","journal-title":"Transl. Lung Cancer Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"111","DOI":"10.25259\/SNI_554_2020","article-title":"A Case of Multiple Synchronously Diagnosed Brain Metastases from Alveolar Soft Part Sarcoma without Concurrent Lung Involvement","volume":"12","author":"Damante","year":"2021","journal-title":"Surg. Neurol. Int."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"785","DOI":"10.21037\/apm-20-2275","article-title":"Successful Treatment of Advanced Alveolar Soft Part Sarcoma with Camrelizumab Combined with Apatinib: A Case Report","volume":"10","author":"Xu","year":"2021","journal-title":"Ann. Palliat. Med."},{"key":"ref_40","first-page":"e8575","article-title":"Hyperprogression of Liver Metastasis with Neoadjuvant Immunotherapy for Soft Tissue Sarcoma","volume":"12","author":"Chan","year":"2020","journal-title":"Cureus"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e1665977","DOI":"10.1080\/2162402X.2019.1665977","article-title":"First Report on Two Cases of Pleomorphic Dermal Sarcoma Successfully Treated with Immune Checkpoint Inhibitors","volume":"8","author":"Klein","year":"2019","journal-title":"Oncoimmunology"},{"key":"ref_42","first-page":"153","article-title":"Will Immunotherapy Change the Role of Spine Radiosurgery in High-Grade Epidural Disease? A Case Report and a Call for an Update of Current Treatment Algorithms","volume":"6","author":"Cramer","year":"2019","journal-title":"J. Radiosurg. SBRT"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Guram, K., Nunez, M., Einck, J., Mell, L.K., Cohen, E., Sanders, P.D., Miyauchi, S., Weihe, E., Kurzrock, R., and Boles, S. (2018). Radiation Therapy Combined with Checkpoint Blockade Immunotherapy for Metastatic Undifferentiated Pleomorphic Sarcoma of the Maxillary Sinus with a Complete Response. Front. Oncol., 8.","DOI":"10.3389\/fonc.2018.00435"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13569-017-0079-1","article-title":"Complete Response of Mediastinal Clear Cell Sarcoma to Pembrolizumab with Radiotherapy","volume":"7","author":"Marcrom","year":"2017","journal-title":"Clin. Sarcoma. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1016\/S0140-6736(24)01812-9","article-title":"Safety and Efficacy of Pembrolizumab, Radiation Therapy, and Surgery Versus Radiation Therapy and Surgery for Stage Iii Soft Tissue Sarcoma of the Extremity (Su2c-Sarc032): An Open-Label, Randomised Clinical Trial","volume":"404","author":"Mowery","year":"2024","journal-title":"Lancet"},{"key":"ref_46","first-page":"e72119","article-title":"Results of an Integrated Phase I\/Ii Prospective Clinical Trial (Nexis) for Neoadjuvant Anti-Pd-L1 (Durvalumab) and Anti-Ctla-4 (Tremelimumab) with Radiation for High-Risk Soft-Tissue Sarcoma of the Trunk and Extremities","volume":"16","author":"Ng","year":"2024","journal-title":"Cureus"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1038\/s43018-024-00726-z","article-title":"A Randomized, Non-Comparative Phase 2 Study of Neoadjuvant Immune-Checkpoint Blockade in Retroperitoneal Dedifferentiated Liposarcoma and Extremity\/Truncal Undifferentiated Pleomorphic Sarcoma","volume":"5","author":"Roland","year":"2024","journal-title":"Nat. Cancer"},{"key":"ref_48","first-page":"1229","article-title":"Effect of Host Immune Capability on Radiocurability and Subsequent Transplantability of a Murine Fibrosarcoma","volume":"63","author":"Stone","year":"1979","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1158\/1535-7163.MCT-21-0991","article-title":"Neoadjuvant Radiation Therapy and Surgery Improves Metastasis-Free Survival over Surgery Alone in a Primary Mouse Model of Soft Tissue Sarcoma","volume":"22","author":"Patel","year":"2023","journal-title":"Mol. Cancer Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"6410","DOI":"10.1038\/s41467-020-19917-0","article-title":"Single Cell Analysis Reveals Distinct Immune Landscapes in Transplant and Primary Sarcomas That Determine Response or Resistance to Immunotherapy","volume":"11","author":"Wisdom","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1056\/NEJMoa1604958","article-title":"Mutations Associated with Acquired Resistance to Pd-1 Blockade in Melanoma","volume":"375","author":"Zaretsky","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"9","DOI":"10.17998\/jlc.2023.11.21","article-title":"Complications of Immunotherapy in Advanced Hepatocellular Carcinoma","volume":"24","author":"Song","year":"2024","journal-title":"J. Liver Cancer"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.intimp.2018.06.001","article-title":"Immune Checkpoint Blockade Therapy for Cancer: An Overview of Fda-Approved Immune Checkpoint Inhibitors","volume":"62","author":"Hargadon","year":"2018","journal-title":"Int. Immunopharmacol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1126\/science.aar4060","article-title":"Cancer Immunotherapy Using Checkpoint Blockade","volume":"359","author":"Ribas","year":"2018","journal-title":"Science"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.ejca.2021.04.034","article-title":"Immune Checkpoint Inhibitors in Treatment of Soft-Tissue Sarcoma: A Systematic Review and Meta-Analysis","volume":"152","author":"Saerens","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"114070","DOI":"10.1016\/j.intimp.2025.114070","article-title":"Efficacy of Immune Checkpoint Inhibitors in the Treatment of Soft Tissue Sarcoma: A Systematic Review and Meta-Analysis of Clinical Trials","volume":"148","author":"Cao","year":"2025","journal-title":"Int. Immunopharmacol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3276","DOI":"10.21037\/tlcr-21-575","article-title":"Hyperprogression under Immunotherapy: A New Form of Immunotherapy Response?\u2014A Narrative Literature Review","volume":"10","author":"Lin","year":"2021","journal-title":"Transl. Lung. Cancer Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1158\/1078-0432.CCR-16-1741","article-title":"Hyperprogressive Disease Is a New Pattern of Progression in Cancer Patients Treated by Anti-Pd-1\/Pd-L1","volume":"23","author":"Champiat","year":"2017","journal-title":"Clin. Cancer Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"4242","DOI":"10.1158\/1078-0432.CCR-16-3133","article-title":"Hyperprogressors after Immunotherapy: Analysis of Genomic Alterations Associated with Accelerated Growth Rate","volume":"23","author":"Kato","year":"2017","journal-title":"Clin. Cancer Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1001\/jamaoncol.2018.3676","article-title":"Hyperprogressive Disease in Patients with Advanced Non-Small Cell Lung Cancer Treated with Pd-1\/Pd-L1 Inhibitors or with Single-Agent Chemotherapy","volume":"4","author":"Ferrara","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1001\/jamaoncol.2021.6439","article-title":"Association of Radiation Therapy with Risk of Adverse Events in Patients Receiving Immunotherapy: A Pooled Analysis of Trials in the Us Food and Drug Administration Database","volume":"8","author":"Anscher","year":"2022","journal-title":"JAMA Oncol."}],"container-title":["Current Issues in Molecular Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1467-3045\/48\/1\/20\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:15:56Z","timestamp":1766726156000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1467-3045\/48\/1\/20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["cimb48010020"],"URL":"https:\/\/doi.org\/10.3390\/cimb48010020","relation":{},"ISSN":["1467-3045"],"issn-type":[{"type":"electronic","value":"1467-3045"}],"subject":[],"published":{"date-parts":[[2025,12,24]]}}}