Centre for Research in Radiotherapy, Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Centre for Research in Radiotherapy, Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Cancer Radiother. 2024 Oct;28(5):484-492. doi: 10.1016/j.canrad.2024.07.002. Epub 2024 Sep 19.
Radiotherapy is widely used to treat various cancers. Its combination with immune checkpoint inhibitors is intensively studied preclinically and clinically. Although the first results were very encouraging, the number of patients who respond positively remains low, and the therapeutic benefit is often temporary. This review summarizes how radiation can stimulate an antitumor immune response and its combination with immunotherapy based on inhibiting immune checkpoints. We will provide an overview of radiotherapy parameters that should be better controlled to avoid downregulating the antitumor immune response. The low response rate of combining radiotherapy and immunotherapy could, at least in part, be caused by the stimulation of cancer cell invasion and metastasis development that occur at similar doses and number of radiation fractions. To end on a positive note, we explore how a targeted inhibition of the inflammatory cytokines induced by radiation with a cyclooxygenase-2 inhibitor could both support an antitumor immune response and block radiation-induced metastasis formation.
放射疗法被广泛用于治疗各种癌症。其与免疫检查点抑制剂的联合治疗在临床前和临床中都得到了深入研究。尽管最初的结果非常令人鼓舞，但积极响应的患者数量仍然较低，治疗效果往往是暂时的。这篇综述总结了放射疗法如何刺激抗肿瘤免疫反应，以及基于抑制免疫检查点的免疫疗法的联合应用。我们将概述应更好地控制放射疗法参数，以避免下调抗肿瘤免疫反应。放射疗法和免疫疗法联合应用的低反应率至少部分可能是由于在相似剂量和放射分割次数下，刺激癌细胞侵袭和转移发展所致。为了以积极的态度结束，我们探讨了如何通过使用环氧化酶-2 抑制剂靶向抑制放射诱导的炎症细胞因子，既能支持抗肿瘤免疫反应，又能阻断放射诱导的转移形成。
