Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Department of Radiation Oncology, Johns Hopkins Cancer Center, Brooklandville, Maryland.
Int J Radiat Oncol Biol Phys. 2020 Sep 1;108(1):227-241. doi: 10.1016/j.ijrobp.2020.05.011. Epub 2020 May 14.
Immunotherapy using immune checkpoint blockade has revolutionized the treatment of many types of cancer. Radiation therapy (RT)-particularly when delivered at high doses using newer techniques-may be capable of generating systemic antitumor effects when combined with immunotherapy in breast cancer. These systemic effects might be due to the local immune-priming effects of RT resulting in the expansion and circulation of effector immune cells to distant sites. Although this concept merits further exploration, several challenges need to be overcome. One is an understanding of how the heterogeneity of breast cancers may relate to tumor immunogenicity. Another concerns the need to develop knowledge and expertise in delivery, sequencing, and timing of RT with immunotherapy. Clinical trials addressing these issues are under way. We here review and discuss the particular opportunities and issues regarding this topic, including the design of informative clinical and translational studies.
免疫检查点阻断的免疫疗法已经彻底改变了许多类型癌症的治疗方法。放射治疗（RT）——尤其是使用新技术进行高剂量治疗时——在与乳腺癌的免疫疗法联合使用时，可能具有产生全身性抗肿瘤作用的能力。这些全身性作用可能是由于 RT 的局部免疫启动作用导致效应免疫细胞的扩增和循环到远处部位。尽管这一概念值得进一步探索，但仍需要克服几个挑战。一个是了解乳腺癌的异质性如何与肿瘤免疫原性相关。另一个问题是需要在免疫治疗中发展关于 RT 的传递、顺序和时机的知识和专业技能。正在进行解决这些问题的临床试验。我们在这里审查和讨论了关于这一主题的具体机会和问题，包括有意义的临床和转化研究的设计。
