Combining Radiation with Immunotherapy: The University of Pennsylvania Experience.
Semin Radiat Oncol
; 30(2): 173-180, 2020 04.
Article
en En
| MEDLINE
| ID: mdl-32381296
ABSTRACT
Immune checkpoint inhibitors have shown remarkable clinical benefit across a variety of cancer types. However, the majority of patients do not respond or develop relapse after therapy. Radiation can favorably modulate the immune system and enhance tumor antigen recognition and rejection. Thus, the combination of radiation and immune checkpoint blockade (ICB) has been recognized as a promising strategy to improve tumor response and broaden the clinical utility of immunotherapy. In this review, we highlight the preclinical and clinical experience at our institution aimed at understanding and promoting the immunostimulatory effect of radiation. We discuss the rationale, design, results, and lessons from our clinical trials in combining radiation with anti-CTLA4 and/or anti-PD-1 therapy. In parallel, our studies to understand the resistance mechanism to radiation and ICB have converged on interferon (IFN) signaling as a key regulatory pathway. Persistent IFN-γ signaling impairs anti-tumor immune responses which can be reversed by using JAK inhibitor to disrupt the IFN signaling. Lastly we discuss remaining challenges, ongoing studies, and future directions in combining radiation with immunotherapy.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Inhibidores de Puntos de Control Inmunológico
/
Neoplasias
Límite:
Animals
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Semin Radiat Oncol
Asunto de la revista:
NEOPLASIAS
/
RADIOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Panamá