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Application mechanisms of radiotherapy combined with immune checkpoint inhibitors
Hui Zhouguang, Yuan Meng, Men Yu
Department of VIP Medical Services (Men Y,Hui ZG), Department of Radiation Oncology (Yuan M),National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China
Abstract Remarkable advances have been made in immunotherapy, especially immune checkpoint inhibitors. However, only less than 30% patients would respond to single checkpoint inhibitors. Radiotherapy can augment the anti-tumor immune responses elicited by immunotherapy, either by way of synergy or complementation. This article reviews the mechanisms, the advances and challenges in combination therapy.
Fund:National Key Research and Development Program (2017YFC1311000,2016YFC0904600);The Founding for Capital Clinical Special Application Research of China (Z171100001017114);CAMS Medical and Health Science and Technology Innovation Program (2016-I2M-1-011);Beijing Hope Run Special Fund of Cancer Foundation of China (LC2016L03)
Cite this article:
Hui Zhouguang,Yuan Meng,Men Yu. Application mechanisms of radiotherapy combined with immune checkpoint inhibitors[J]. Chinese Journal of Radiation Oncology, 2018, 27(10): 875-879.
Hui Zhouguang,Yuan Meng,Men Yu. Application mechanisms of radiotherapy combined with immune checkpoint inhibitors[J]. Chinese Journal of Radiation Oncology, 2018, 27(10): 875-879.
[1] Ribatti D.The concept of immune surveillance against tumors. The first theories[J].Oncotarget,2017,8(4):7175-7180.DOI:10.18632/oncotarget.12739. [2] Herrera FG,Bourhis J,Coukos G.Radiotherapy combination opportunities leveraging immunity for the next oncology practice[J].CA Cancer J Clin,2017,67(1):65-85.DOI:10.3322/caac.21358. [3] Bloy N,Pol J,Manic G,et al. Trial watch:radioimmunotherapy for oncological indications[J].Oncoimmunology,2014,3(9):e954929.DOI:10.4161/21624011.2014.954929. [4] Gupta A,Probst HC,Vuong V,et al. Radiotherapy promotes tumor-specific effector CD8(+) T cells via dendritic cell activation[J].J Immunol,2012,189(2):558-566.DOI:10.4049/jimmunol.1200563. [5] Tabi Z,Spary LK,Coleman S,et al. Resistance of CD45RA-T cells to apoptosis and functional impairment,and activation of tumor-antigen specific T cells during radiation therapy of prostate cancer[J].J Immunol,2010,185(2):1330-1339.DOI:10.4049/jimmunol.1000488. [6] Deloch L,Derer A,Hartmann J,et al. Modern radiotherapy concepts and the impact of radiation on immune activation[J].Front Oncol,2016,6:141.DOI:10.3389/fonc.2016.00141. [7] Chakraborty M,Abrams SI,Coleman CN,et al. External beam radiation of tumors alters phenotype of tumor cells to render them susceptible to vaccine-mediated T-cell killing[J].Cancer Res,2004,64(12):4328-4337.DOI:10.1158/0008-5472.CAN-04-0073. [8] Reits EA,Hodge JW,Herberts CA,et al. Radiation modulates the peptide repertoire,enhances MHC class Ⅰ expression,and induces successful antitumor immunotherapy[J].J Exp Med,2006,203(5):1259-1271.DOI:10.1084/jem.20052494. [9] Klug F,Prakash H,Huber PE,et al. Low-dose irradiation programs macrophage differentiation to an iNOS (+)/M1 phenotype that orchestrates effective T cell immunotherapy[J].Cancer Cell,2013,24(5):589-602.DOI:10.1016/j.ccr.2013.09.014.Epub 2013 Oct 24. [10] Walle T,Martinez MR,Cerwenka A,et al. Radiation effects on antitumor immune responses:current perspectives and challenges[J].Ther Adv Med Oncol,2018,10:1960357615.DOI:10.1177/1758834017742575. [11] Beal AM,Ramos-Hernandez N,Riling CR,et al. TGF-beta induces the expression of the adaptor Ndfip1 to silence IL-4 production during iTreg cell differentiation[J].Nat Immunol,2011,13(1):77-85.DOI:10.1038/ni.2154. [12] Vatner RE,Formenti SC.Myeloid-derived cells in tumors:effects of radiation[J].Semin Radiat Oncol,2015,25(1):18-27.DOI:10.1016/j.semradonc.2014.07.008. [13] Fife BT,Bluestone JA.Control of peripheral T-cell tolerance and autoimmunity via the CTLA-4 and PD-1 pathways[J].Immunol Rev,2008,224:166-182.DOI:10.1111/j.1600-065X.2008.00662.x. [14] Sakaguchi S.Regulatory T cells:history and perspective[J]. Methods Mol Biol,2011,707:3-17.DOI:10.1007/978-1-61737-979-6_1. [15] Twyman-Saint VC,Rech AJ,Maity A,et al. Radiation and dual checkpoint blockade activate non-redundant immune mechanisms in cancer[J].Nature,2015,520(7547):373-377.DOI:10.1038/nature14292. [16] Deng L,Liang H,Burnette B,et al. Irradiation and anti-PD-L1 treatment synergistically promote antitumor immunity in mice[J].J Clin Invest,2014,124(2):687-695.DOI:10.1172/JCI67313. [17] Postow MA,Callahan MK,Barker CA,et al. Immunologic correlates of the abscopal effect in a patient with melanoma[J].N Engl J Med,2012,366(10):925-931.DOI:10.1056/NEJMoa1112824. [18] Hiniker SM,Chen DS,Reddy S,et al. A systemic complete response of metastatic melanoma to local radiation and immunotherapy[J].Transl Oncol,2012,5(6):404-407. [19] Shaverdian N,Lisberg AE,Bornazyan K,et al. Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small-cell lung cancer:a secondary analysis of the KEYNOTE-001 phase Ⅰ trial[J].Lancet Oncol,2017.DOI:10.1016/S1470-2045(17)30380-7. [20] Antonia SJ,Villegas A,Daniel D,et al. Durvalumab after chemoradiotherapy in stage Ⅲ non-small-cell lung cancer[J].N Engl J Med,2017,377(20):1919-1929.DOI:10.1056/NEJMoa1709937. [21] Surace L,Lysenko V,Fontana AO,et al. Complement is a central mediator of radiotherapy-induced tumor-specific immunity and clinical response[J].Immunity,2015,42(4):767-777.DOI:10.1016/j.immuni.2015.03.009. [22] Qin R,Olson A,Singh B,et al. Safety and efficacy of radiation therapy in advanced melanoma patients treated with ipilimumab[J].Int J Radiat Oncol Biol Phys,2016,96(1):72-77.DOI:10.1016/j.ijrobp.2016.04.017. [23] Belcaid Z,Phallen JA,Zeng J,et al. Focal radiation therapy combined with 4-1BB activation and CTLA-4 blockade yields long-term survival and a protective antigen-specific memory response in a murine glioma model[J/OL].PLoS One,2014,9(7):e101764.DOI:10.1371/journal.pone.0101764. [24] Skrepnik T,Sundararajan S,Cui H,et al. Improved time to disease progression in the brain in patients with melanoma brain metastases treated with concurrent delivery of radiosurgery and ipilimumab[J].Oncoimmunology,2017,6(3):e1283461.DOI:10.1080/2162402X.2017.1283461. [25] Gupta A,Probst HC,Vuong V,et al. Radiotherapy promotes tumor-specific effector CD8(+) T cells via dendritic cell activation[J].J Immunol,2012,189(2):558-566.DOI:10.4049/jimmunol.1200563. [26] Teng F,Kong L,Meng X,et al. Radiotherapy combined with immune checkpoint blockade immunotherapy:achievements and challenges[J].Cancer Lett,2015,365(1):23-29.DOI:10.1016/j.canlet.2015.05.012. [27] Dewan MZ,Galloway AE,Kawashima N,et al. Fractionated but not single-dose radiotherapy induces an immune-mediated abscopal effect when combined with anti-CTLA-4 antibody[J].Clin Cancer Res,2009,15(17):5379-5388.DOI:10.1158/1078-0432.CCR-09-0265. [28] Tharmalingam H,Hoskin PJ.The optimism surrounding stereotactic body radiation therapy and immunomodulation[J].Chin Clin Oncol,2017,6(Suppl 2):S9.DOI:10.21037/cco.2017.05.01. [29] Yarchoan M,Hopkins A,Jaffee EM.Tumor mutational burden and response rate to PD-1 inhibition[J].N Engl J Med,2017,377(25):2500-2501.DOI:10.1056/NEJMc1713444. [30] Steuer CE,Ramalingam SS.Tumor mutation burden:leading immunotherapy to the era of precision medicine?[J].J Clin Oncol,2018,36(7):631-632.DOI:10.1200/JCO.2017.76.8770. [31] Tumeh PC,Harview CL,Yearley JH,et al. PD-1 blockade induces responses by inhibiting adaptive immune resistance[J].Nature,2014,515(7528):568-571.DOI:10.1038/nature13954. [32] Mezquita L,Auclin E,Ferrara R,et al. Association of the lung immune prognostic index with immune checkpoint inhibitor outcomes in patients with advanced non-small cell lung cancer[J].JAMA Oncol,2018.DOI:10.1001/jamaoncol.2017.4771. [33] Brahmer JR,Lacchetti C,Schneider BJ,et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy:american society of clinical oncology clinical practice guideline[J].J Clin Oncol,2018:O2017776385.DOI:10.1200/JCO.2017.77.6385. [34] Khoja L,Day D,Wei-Wu CT,et al. Tumour-and class-specific patterns of immune-related adverse events of immune checkpoint inhibitors:a systematic review[J].Ann Oncol,2017,28(10):2377-2385.DOI:10.1093/annonc/mdx286. [35] Hwang WL,Niemierko A,Hwang KL,et al. Clinical outcomes in patients with metastatic lung cancer treated with PD-1/PD-L1 inhibitors and thoracic radiotherapy[J].JAMA Oncol,2018,4(2):253-255.DOI:10.1001/jamaoncol.2017.3808.