Division of Hematology/Oncology, Department of Internal Medicine, Data Management and Clinical Research Unit, Naef K. Basile Cancer Institute- NKBCI American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Lebanon.
Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon.
Med Oncol. 2017 Aug 21;34(9):165. doi: 10.1007/s12032-017-1025-z.
Radiation therapy and immunotherapy are two highly evolving modalities for the treatment of solid tumors. Immunotherapeutic drugs can either stimulate the immune system via immunogenic pathways or target co-inhibitory checkpoints. An augmented tumor cell recognition by host immune cells can be achieved post-irradiation, as irradiated tissues can release chemical signals which are sensed by the immune system resulting in its activation. Different strategies combining both treatment modalities were tested in order to achieve a better therapeutic response and longer tumor control. Both regimens act synergistically to one another with complimentary mechanisms. In this review, we explore the scientific basis behind such a combination, starting initially with a brief historical overview behind utilizing radiation and immunotherapies for solid tumors, followed by the different types of these two modalities, and the biological concept behind their synergistic effect. We also shed light on the common side effects and toxicities associated with radiation and immunotherapy. Finally, we discuss previous clinical trials tackling this multimodality combination and highlight future ongoing research.
放射治疗和免疫疗法是治疗实体瘤的两种高度发展的方法。免疫治疗药物可以通过免疫原性途径刺激免疫系统，或针对共抑制检查点。宿主免疫细胞对肿瘤细胞的识别能力可以在放射后增强，因为放射后的组织可以释放化学信号，被免疫系统感知，从而激活免疫系统。为了获得更好的治疗反应和更长的肿瘤控制，已经测试了不同的联合两种治疗方法的策略。这两种方案相互协同作用，具有互补的机制。在这篇综述中，我们探讨了这种联合的科学基础，首先简要回顾一下利用放射和免疫疗法治疗实体瘤的历史背景，然后介绍这两种方法的不同类型，以及它们协同作用的生物学概念。我们还阐述了与放射和免疫治疗相关的常见副作用和毒性。最后，我们讨论了以前处理这种多模态联合治疗的临床试验，并强调了正在进行的未来研究。
