Discovery of biomarkers in the era of radioimmunotherapy against lung cancer: A bench-to-bedside promise.

In the recent decade, immunotherapy has improved lung cancer treatment. However, mono-immunotherapy has substantial clinical limitations, such as low objective response rates, leading to the requirement of combinatorial regimens. Radiation treatment has received attention due to its potential to provide a strong immune-stimulatory milieu for immunotherapy synergy. However, the clinical outcomes of radioimmunotherapy against lung cancer have been conflicting. While many unsuccessful trials employed concurrent regimens often hampered by cumulative toxicities that disrupted treatment delivery, successful strategies typically featured sequential immunotherapy after radiotherapy. These facts drive three key research questions: identifying predictive biomarkers, optimizing treatment sequence, and developing markers for toxicity prediction and safety management. In this review, biomarkers for addressing these three issues are summarized, offering a novel insight into advancing precise radioimmunotherapy against lung cancer and improving the scientific allocation of healthcare resources.