Jiang Minhan, Fiering Steven, Shao Qi
Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States.
Department of Microbiology and Immunology, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States.
Front Oncol. 2023 May 1;13:1153066. doi: 10.3389/fonc.2023.1153066. eCollection 2023.
Energy-based focal therapy (FT) uses targeted, minimally invasive procedures to destroy tumors while preserving normal tissue and function. There is strong emerging interest in understanding how systemic immunity against the tumor can occur with cancer immunotherapy, most notably immune checkpoint inhibitors (ICI). The motivation for combining FT and ICI in cancer management relies on the synergy between the two different therapies: FT complements ICI by reducing tumor burden, increasing objective response rate, and reducing side effects of ICI; ICI supplements FT by reducing local recurrence, controlling distal metastases, and providing long-term protection. This combinatorial strategy has shown promising results in preclinical study (since 2004) and the clinical trials (since 2011). Understanding the synergy calls for understanding the physics and biology behind the two different therapies with distinctive mechanisms of action. In this review, we introduce different types of energy-based FT by covering the biophysics of tissue-energy interaction and present the immunomodulatory properties of FT. We discuss the basis of cancer immunotherapy with the emphasis on ICI. We examine the approaches researchers have been using and the results from both preclinical models and clinical trials from our exhaustive literature research. Finally, the challenges of the combinatory strategy and opportunities of future research is discussed extensively.
基于能量的聚焦治疗（FT）采用靶向、微创的方法来破坏肿瘤，同时保留正常组织和功能。人们对了解癌症免疫疗法，尤其是免疫检查点抑制剂（ICI）如何引发针对肿瘤的全身免疫越来越感兴趣。在癌症治疗中联合使用FT和ICI的动机在于两种不同疗法之间的协同作用：FT通过减轻肿瘤负担、提高客观缓解率和减少ICI的副作用来补充ICI；ICI通过减少局部复发、控制远处转移和提供长期保护来补充FT。这种联合策略在临床前研究（自2004年起）和临床试验（自2011年起）中已显示出有前景的结果。理解这种协同作用需要了解这两种具有独特作用机制的不同疗法背后的物理和生物学原理。在本综述中，我们通过阐述组织 - 能量相互作用的生物物理学来介绍不同类型的基于能量的FT，并展示FT的免疫调节特性。我们讨论癌症免疫疗法的基础，重点是ICI。我们研究了研究人员一直采用的方法以及我们通过详尽的文献研究从临床前模型和临床试验中获得的结果。最后，广泛讨论了联合策略面临的挑战和未来研究的机遇。
