Unlocking the combination: potentiation of radiation-induced antitumor responses with immunotherapy

MM Wattenberg, A Fahim, MM Ahmed… - Radiation …, 2014 - meridian.allenpress.com
MM Wattenberg, A Fahim, MM Ahmed, JW Hodge
Radiation research, 2014meridian.allenpress.com
There is increasing evidence of the potential for radiation therapy to generate antitumor
immune responses. The mechanisms of this immune-activating potential include actions on
tumor cells such as immunogenic cell death and phenotypic change. Radiation modulates
tumor cell surface expression of cell death receptors, tumor-associated antigens and
adhesion molecules. This process of immunomodulation sensitizes tumor cells to immune-
mediated killing. Radiation also affects immune compartments, including antigen-presenting …
There is increasing evidence of the potential for radiation therapy to generate antitumor immune responses. The mechanisms of this immune-activating potential include actions on tumor cells such as immunogenic cell death and phenotypic change. Radiation modulates tumor cell surface expression of cell death receptors, tumor-associated antigens and adhesion molecules. This process of immunomodulation sensitizes tumor cells to immune-mediated killing. Radiation also affects immune compartments, including antigen-presenting cells, cytotoxic T lymphocytes and humoral immunity, leading to specific antitumor immune responses. Recognizing the importance of immunity as a potentiator of response to radiation leads to rational augmentation of antitumor immunity by combining radiation and immunotherapy. Targeted immunotherapy manipulates the immune system in a way that best synergizes with radiation. This article discusses the ability of radiation monotherapy to induce antitumor immunity, with a focus on the effect of radiation on antigen-presenting cells and cytotoxic T lymphocytes. We define two important responses generated by tumor cells, immunogenic cell death and immunomodulation, both of which are radiation dose-dependent. In conclusion, we describe the translation of several combination therapies from the preclinical to the clinical setting and identify opportunities for further exploration.
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