The future of radiation-induced abscopal response: Beyond conventional radiotherapy approaches

Slavisa Tubin, Weisi Yan, Waleed F. Mourad, Piero Fossati, Mohammad K. Khan*

*Corresponding author for this work

Research output: Journal article (peer-reviewed)Review article

26 Citations (Scopus)

Abstract

Advances in the immunological pharmaceuticals, such as checkpoint inhibitors and agonists, have positive implications for the future of the radiotherapy abscopal response. A once rare phenomenon, whereby distant nonirradiated tumor sites regressed after radiotherapy alone, may become more common when combined with the immune modulating agents. Radiotherapy can increase neoantigen expression, increased tumor PD-L1 expression, increase MHC class I expression, reverse exhausted CD8 T cells and increase tumor-infiltrating tumors within the tumor microenvironment. These changes in the tumor and the tumor microenvironment after radiotherapy could potentiate responses to anti-CTL-4, anti-PD-L1/PD-1 and other immunotherapy agents. Thus, advances in checkpoint inhibitors have increased interest in re-evaluation of the role of conventional radiotherapy approaches on the immune system. We reviewed newer nonconventional approaches such as SBRT-PATHY, GRID, FLASH, carbon ion and proton therapy and their role in eliciting immune responses. We believe that combining these novel radiation methods may enhance the outcome with the newly US FDA approved immune modulating agents.

Original languageEnglish
Pages (from-to)1137-1151
Number of pages15
JournalFuture Oncology
Volume16
Issue number16
DOIs
Publication statusPublished - Jun 2020
Externally publishedYes

Keywords

  • abscopal response
  • bystander effects
  • carbon ion
  • checkpoint inhibitors
  • FLASH
  • GRID
  • immunotherapy
  • nontargeted effects
  • proton
  • radiotherapy
  • SBRT-PATHY

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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