Radiotherapy and immunotherapy: a beneficial liaison?

Nat Rev Clin Oncol. 2017 Jun;14(6):365-379. doi: 10.1038/nrclinonc.2016.211. Epub 2017 Jan 17.

Abstract

Investigations into the interaction between radiotherapy and the host immune system have uncovered new mechanisms that can potentially be exploited to improve the efficacy of radiotherapy. Radiation promotes the release of danger signals and chemokines that recruit inflammatory cells into the tumour microenvironment, including antigen-presenting cells that activate cytotoxic T-cell function. By contrast, radiation can attract immunosuppressive cells into the tumour microenvironment. In rare circumstances, the antitumour effect of radiotherapy has been observed outside of the radiation field, known as the abscopal effect. This phenomenon is proposed to have an immune origin and indicates that local radiotherapy elicits systemic effects. Herein, we highlight data that provide new mechanistic explanations for the success or failure of radiotherapy, and postulate how the combination of immune-modulation and radiation could tip the balance of the host immune response to promote cure. We use the concept of radiation- induced tumour equilibrium (RITE) as a starting point to discuss the mechanistic influence of immune-checkpoint therapies on radiotherapy efficacy.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity / radiation effects
  • Combined Modality Therapy
  • Humans
  • Immunity, Innate / radiation effects
  • Immunotherapy*
  • Neoplasms / immunology
  • Neoplasms / radiotherapy
  • Neoplasms / therapy*
  • Tumor Microenvironment / immunology
  • Tumor Microenvironment / radiation effects