Adnan Ather, Muñoz Nina M, Prakash Punit, Habibollahi Peiman, Cressman Erik N K, Sheth Rahul A
Texas A&M Health Science Center, Texas A&M College of Medicine, Houston, TX 77030, USA.
Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Cancers (Basel). 2021 May 21;13(11):2507. doi: 10.3390/cancers13112507.
Thermal ablation is a cornerstone in the management of cancer patients. Typically, ablation procedures are performed for patients with a solitary or oligometastatic disease with the intention of eradicating all sites of the disease. Ablation has traditionally played a less prominent role for patients with a widely metastatic disease. For such patients, attempting to treat numerous sites of disease compounds potential risks without a clear clinical benefit and, as such, a compelling justification for performing an intervention that is unlikely to alter a patient's clinical trajectory is uncommon. However, the discovery of immune checkpoints and the development of immune checkpoint inhibitors have brought a new perspective to the relevance of local cancer therapies such as ablation for patients with a metastatic disease. It is becoming increasingly apparent that local cancer therapies can have systemic immune effects. Thus, in the new perspective of cancer care centered upon immunologic principles, there is a strong interest in exploring the utility of ablation for patients with a metastatic disease for its immunologic implications. In this review, we summarize the unmet clinical need for adjuvant interventions such as ablation to broaden the impact of systemic immunotherapies. We additionally highlight the extant preclinical and clinical data for the immunogenicity of common thermal ablation modalities.
热消融是癌症患者治疗的基石。通常，消融手术针对患有孤立性或寡转移性疾病的患者进行，旨在根除疾病的所有病灶。传统上，消融对于广泛转移性疾病患者的作用不太显著。对于此类患者，试图治疗众多疾病部位会增加潜在风险，却无明确的临床益处，因此，对于进行一项不太可能改变患者临床病程的干预措施，很少有令人信服的理由。然而，免疫检查点的发现以及免疫检查点抑制剂的研发，为局部癌症治疗（如消融）对于转移性疾病患者的相关性带来了新的视角。越来越明显的是，局部癌症治疗可产生全身免疫效应。因此，在以免疫学原理为中心的癌症治疗新视角下，人们对探索消融对转移性疾病患者的效用及其免疫学意义有着浓厚兴趣。在本综述中，我们总结了辅助干预措施（如消融）尚未满足的临床需求，以扩大全身免疫疗法的影响。我们还重点介绍了常见热消融方式免疫原性的现有临床前和临床数据。
