Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy.
Macerata Hospital, Macerata, Italy.
Curr Drug Targets. 2020;21(14):1463-1475. doi: 10.2174/1389450121666200311121540.
The management of renal cell carcinoma is rapidly evolving and immunotherapy, mostly consisting of immune checkpoint inhibitors, is revolutionizing the treatment scenario of metastatic patients. Novel fractionation schedules of radiotherapy, consisting of high doses in few fractions, can overcome the radioresistance of this tumor. Localized radiotherapy is associated with a systemic effect, known as the abscopal effect. This effect mediated by the immune system can be enhanced associating radiotherapy with immunotherapy.
In this review, we explore the role of radiotherapy and immunotherapy in RCC, the rationale of combining these strategies and the on-going clinical trials investigating combinations of these two treatment modalities.
Combining immunotherapy and radiotherapy has a strong rationale and pre-clinical studies support their association because it can overcome the immunosuppression of the tumor microenvironment and increase the anti-tumor immune response. More clinical evidence, deriving from onclinical trials, are needed to prove the efficacy and safety of these treatments combined.
肾癌的治疗正在迅速发展，免疫疗法（主要包括免疫检查点抑制剂）正在彻底改变转移性患者的治疗格局。由高剂量分割成少数几次的新型放疗分割方案可以克服这种肿瘤的放射抵抗性。局部放疗与一种称为远隔效应的全身效应相关。这种由免疫系统介导的效应可以通过将放疗与免疫疗法相结合来增强。
在这篇综述中，我们探讨了放疗和免疫疗法在肾细胞癌中的作用、联合这些策略的原理，以及正在进行的临床试验，以研究这两种治疗方法的联合应用。
免疫疗法和放疗联合具有很强的理论基础，而且临床前研究支持它们的联合应用，因为它可以克服肿瘤微环境的免疫抑制，增强抗肿瘤免疫反应。需要更多的临床证据，来自临床试验，来证明这些联合治疗的疗效和安全性。
