Seyedin Steven N, Schoenhals Jonathan E, Lee Dean A, Cortez Maria A, Wang Xiaohong, Niknam Sharareh, Tang Chad, Hong David S, Naing Aung, Sharma Padmanee, Allison James P, Chang Joe Y, Gomez Daniel R, Heymach John V, Komaki Ritsuko U, Cooper Laurence J, Welsh James W
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Department of Experimental Radiation Oncology, University of Texas MD Anderson Cancer Center, TX, USA.
Immunotherapy. 2015;7(9):967-980. doi: 10.2217/imt.15.65. Epub 2015 Aug 27.
Radiation therapy controls local disease but also prompts the release of tumor-associated antigens and stress-related danger signals that primes T cells to promote tumor regression at unirradiated sites known as the abscopal effect. This may be enhanced by blocking inhibitory immune signals that modulate immune activity through a variety of mechanisms. Indeed, abscopal responses have occurred in patients with lung cancer or melanoma when given anti-CTLA4 antibody and radiation. Other approaches involve expanding and reinfusing T or NK cells or engineered T cells to express receptors that target specific tumor peptides. These approaches may be useful for immunocompromised patients receiving radiation. Preclinical and clinical studies are testing both immune checkpoint-based strategies and adoptive immunotherapies with radiation.
放射治疗可控制局部疾病，但也会促使肿瘤相关抗原和应激相关危险信号的释放，这些信号会使T细胞致敏，从而促进未受照射部位的肿瘤消退，即所谓的远隔效应。通过阻断通过多种机制调节免疫活性的抑制性免疫信号，这一效应可能会增强。事实上，肺癌或黑色素瘤患者在接受抗CTLA4抗体和放射治疗时会出现远隔反应。其他方法包括扩增和回输T细胞或NK细胞，或改造T细胞以表达靶向特定肿瘤肽的受体。这些方法可能对接受放疗的免疫功能低下患者有用。临床前和临床研究正在测试基于免疫检查点的策略以及放疗联合过继性免疫疗法。
