Brooks Eric D, Schoenhals Jonathan E, Tang Chad, Micevic Goran, Gomez Daniel R, Chang Joe Y, Welsh James W
From the *Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Departments of †Experimental Radiation Oncology and ‡Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; and Departments of §Dermatology and ∥Pathology, Yale University School of Medicine, New Haven, CT.
Cancer J. 2016 Jul-Aug;22(4):257-66. doi: 10.1097/PPO.0000000000000210.
Immunotherapy, particularly immune-checkpoint inhibition, is producing encouraging clinical responses and affecting the way numerous cancers are treated. Yet immune-checkpoint therapy is not effective for many patients, and even those who initially respond can experience relapse, fueling interest in finding new processes or tools to improve the effectiveness of these novel therapeutics. One such tool is radiation. Both preclinical and clinical studies have demonstrated that the systemic effects of immunotherapy can be amplified when it is used in combination with radiation and, conversely, that the immunogenic effects of local irradiation can be amplified and extended to distant sites when used with immunotherapy. We review how stereotactic ablative radiation therapy, a technique specifically indicated for tumors treated with immune-checkpoint inhibitors, can potentiate the effects of immune-checkpoint therapy. We further explore how these novel therapeutics may transform radiation, previously considered a local treatment option, into powerful systemic therapy.
免疫疗法,尤其是免疫检查点抑制疗法,正在产生令人鼓舞的临床反应,并影响着多种癌症的治疗方式。然而,免疫检查点疗法对许多患者并不有效,甚至那些最初有反应的患者也可能复发,这激发了人们寻找新方法或工具来提高这些新型疗法有效性的兴趣。其中一种工具就是放疗。临床前和临床研究均已表明,免疫疗法与放疗联合使用时,其全身效应可得到增强;相反,局部放疗与免疫疗法联合使用时,其免疫原性效应可得到增强并扩展至远处部位。我们综述了立体定向消融放疗(一种专门用于接受免疫检查点抑制剂治疗的肿瘤的技术)如何增强免疫检查点疗法的效果。我们还进一步探讨了这些新型疗法如何将放疗(以前被认为是一种局部治疗选择)转变为强大的全身治疗方法。