Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH 43614, USA.
Department of Medical Affairs, Gradalis, Inc, Carrollton, TX 75006, USA.
Future Oncol. 2021 May;17(13):1683-1694. doi: 10.2217/fon-2020-0994. Epub 2021 Mar 17.
Radiation therapy (RT) in some cases results in a systemic anticancer response known as the abscopal effect. Multiple hypotheses support the role of immune activation initiated by RT-induced DNA damage. Optimal radiation dose is necessary to promote the cGAS-STING pathway in response to radiation and initiate an IFN-1 signaling cascade that promotes the maturation and migration of dendritic cells to facilitate antigen presentation and stimulation of cytotoxic T cells. T cells then exert a targeted response throughout the body at areas not subjected to RT. These effects are further augmented through the use of immunotherapeutic drugs resulting in increased T-cell activity. Tumor-infiltrating lymphocyte presence and TREX1, KPNA2 and p53 signal expression are being explored as prognostic biomarkers.
放疗（RT）在某些情况下会产生一种称为远隔效应的全身性抗癌反应。多种假说支持 RT 诱导的 DNA 损伤引发免疫激活的作用。最佳辐射剂量是促进 cGAS-STING 途径对辐射作出反应并启动 IFN-1 信号级联反应所必需的，该级联反应促进树突状细胞的成熟和迁移，从而促进抗原呈递和细胞毒性 T 细胞的刺激。然后，T 细胞在全身未接受 RT 的区域发挥靶向反应。通过使用免疫治疗药物进一步增强这些作用，从而增加 T 细胞的活性。肿瘤浸润淋巴细胞的存在以及 TREX1、KPNA2 和 p53 信号表达正在作为预后生物标志物进行探索。
