Serre R, Deutsch E, Huguet F, Pointreau Y
Department of Radiation Oncology, Centre Hospitalier Universitaire Dupuytren, Limoges, France, Inria-Inserm team COMPO, Marseille, France.
Gustave Roussy Cancer Campus, Villejuif, France, Université Paris-Saclay, Ile-de-France, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France; Inserm U1030, Radiothérapie Moléculaire et Innovation Thérapeutique, Villejuif, France.
Cancer Radiother. 2022 Oct;26(6-7):955-961. doi: 10.1016/j.canrad.2022.06.027. Epub 2022 Aug 24.
Thanks to the success of checkpoint inhibitors, immunotherapy now plays a major role in the management of a large number of solid tumors, while the number of indications continues to grow and new combinations could, in the near future, further modify treatment standards. However, the response rates of immunotherapies as monotherapy are modest and their use is increasingly considered in combination with other cancer treatments (chemotherapy, surgery, radiotherapy or certain targeted therapies). Combinations with radiotherapy seem particularly attractive because there is a strong experimental rationale linking part of the efficacy of ionizing radiation to an induced stimulation of both of the innate and adaptive response. Many early phases and a number of large randomized combination trials have published efficacy and safety results, while important trials are still ongoing and will provide answers in the near future. This short review recalls the experimental biological rationale for immuno-radiotherapy and highlights some of the fundamental directions being explored, then presents the clinical efficacy and safety results available to date, those expected in the near future, and finally outlines the outlook in this rapidly evolving field.
得益于检查点抑制剂的成功,免疫疗法如今在大量实体瘤的治疗中发挥着重要作用,同时适应证数量持续增加,新的联合方案在不久的将来可能会进一步改变治疗标准。然而,免疫疗法单药治疗的缓解率并不高,其与其他癌症治疗方法(化疗、手术、放疗或某些靶向治疗)联合使用的情况越来越多。与放疗联合似乎特别有吸引力,因为有强有力的实验依据表明,电离辐射的部分疗效与诱导刺激先天免疫和适应性免疫反应有关。许多早期阶段的研究以及一些大型随机联合试验已经公布了疗效和安全性结果,同时重要试验仍在进行中,将在不久的将来给出答案。这篇简短的综述回顾了免疫放疗的实验生物学原理,强调了一些正在探索的基本方向,接着介绍了迄今为止可用的临床疗效和安全性结果、不久的将来预期的结果,最后概述了这个快速发展领域的前景。