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Beyond success: unveiling the hidden potential of radiotherapy and immunotherapy in solid tumors

机译:超越成功:揭示放射治疗和免疫治疗在实体瘤中的隐藏潜力

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摘要

Immunotherapy, particularly with immune checkpoint inhibitors, has significantly transformed cancer treatment. Despite its success, many patients struggle to respond adequately or sustain long‐lasting clinical improvement. A growing consensus has emerged that radiotherapy (RT) enhances the response rate and overall efficacy of immunotherapy. Although combining RT and immunotherapy has been extensively investigated in preclinical models and has shown promising results, establishing itself as a dynamic and thriving area of research, clinical evidence for this combination strategy over the past five years has shown both positive and disappointing results, suggesting the need for a more nuanced understanding. This review provides a balanced and updated analysis of the combination of immunotherapy and RT. We summarized the preclinical mechanisms through which RT boosts antitumor immune responses and mainly focused on the outcomes of recently updated clinical trials, including those that may not have met expectations. We investigated the optimization of the therapeutic potential of this combined strategy, including key challenges, such as fractionation and scheduling, lymph node irradiation, and toxicity. Finally, we offered insights into the prospects and challenges associated with the clinical translation of this combination therapy, providing a realistic perspective on the current state of research and potential future directions.
机译:免疫疗法,尤其是免疫检查点抑制剂,已经显着改变了癌症治疗。尽管取得了成功,但许多患者难以做出充分反应或维持持久的临床改善。越来越多的共识是,放疗 (RT) 可以提高免疫治疗的反应率和整体疗效。尽管 RT 和免疫疗法的联合治疗已在临床前模型中进行了广泛研究,并显示出有希望的结果,使其成为一个充满活力和繁荣的研究领域,但在过去五年中,这种联合疗法的临床证据显示出积极和令人失望的结果,这表明需要更细致的理解。本综述对免疫疗法和 RT 的联合进行了平衡和更新的分析。我们总结了 RT 增强抗肿瘤免疫反应的临床前机制,主要关注最近更新的临床试验的结果,包括那些可能没有达到预期的试验。我们研究了这种联合策略治疗潜力的优化,包括关键挑战,例如分割和调度、淋巴结照射和毒性。最后,我们提供了与这种联合疗法的临床转化相关的前景和挑战的见解,为研究现状和潜在的未来方向提供了现实的视角。

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