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    Stereotactic ablative radiotherapy and immunotherapy combinations: turning the future into systemic therapy?

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    Authors
    Walshaw, Richard
    Honeychurch, Jamie
    Illidge, Timothy M
    Affiliation
    Institute of Cancer Sciences, Manchester Cancer Research Centre, Manchester Academic Health Sciences Centre, University of Manchester, The Christie Hospital, Manchester M20 4BX
    Issue Date
    2016-10
    
    Metadata
    Show full item record
    Abstract
    Radiotherapy (RT) is effective at cytoreducing tumours and until relatively recently the focus in radiobiology has been on the direct effects of RT on the tumour. Increasingly, however, the effect of RT on the tumour vasculature, tumour stroma and immune system are recognized as important to the overall outcome. RT is known to lead to the induction of immunogenic cell death (ICD), which can generate tumour-specific immunity. However, systemic immunity leading to "abscopal effects" resulting in tumour shrinkage outside of the RT treatment field is rare, which is thought to be caused by the immunosuppressive nature of the tumour microenvironment. Recent advances in understanding the nature of this immunosuppression and therapeutics targeting immune checkpoints such as programmed death 1 has led to durable clinical responses in a range of cancer types including malignant melanoma and non-small-cell lung cancer. The effects of RT dose and fraction on the generation of ICD and systemic immunity are largely unknown and are currently under investigation. Stereotactic ablative radiotherapy (SABR) provides an opportunity to deliver single or hypofractionated large doses of RT and potentially increase the amount of ICD and the generation of systemic immunity. Here, we review the interplay of RT and the tumour microenvironment and the rationale for combining SABR with immunomodulatory agents to generate systemic immunity and improve outcomes.
    Citation
    Stereotactic ablative radiotherapy and immunotherapy combinations: turning the future into systemic therapy? 2016, 89 (1066):20160472 Br J Radiol
    Journal
    The British Journal of Radiology
    URI
    http://hdl.handle.net/10541/619958
    DOI
    10.1259/bjr.20160472
    PubMed ID
    27556933
    Type
    Article
    Language
    en
    ISSN
    1748-880X
    ae974a485f413a2113503eed53cd6c53
    10.1259/bjr.20160472
    Scopus Count
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