Translational Frontiers and Clinical Opportunities of Immunologically Fitted Radiotherapy

Ionizing radiation can have a wide range of impacts on tumor-immune interactions, which are being studied with the greatest interest and at an accelerating pace by the medical community. Despite its undeniable immunostimulatory potential, it clearly appears that radiotherapy as it is prescribed and...

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Bibliographic Details
Published in:Clinical cancer research 2024-06, Vol.30 (11), p.2317-OF16
Main Authors: Morel, Daphné, Robert, Charlotte, Paragios, Nikos, Grégoire, Vincent, Deutsch, Eric
Format: Article
Language:English
Subjects:
Animals
Humans
Immunotherapy
Immunotherapy - methods
Life Sciences
Neoplasms
Neoplasms - immunology
Neoplasms - radiotherapy
Radiation Oncology
Radiotherapy
Radiotherapy - adverse effects
Radiotherapy - methods
Reviews
Translational Research, Biomedical
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Summary:Ionizing radiation can have a wide range of impacts on tumor-immune interactions, which are being studied with the greatest interest and at an accelerating pace by the medical community. Despite its undeniable immunostimulatory potential, it clearly appears that radiotherapy as it is prescribed and delivered nowadays often alters the host's immunity toward a suboptimal state. This may impair the full recovery of a sustained and efficient antitumor immunosurveillance posttreatment. An emerging concept is arising from this awareness and consists of reconsidering the way of designing radiation treatment planning, notably by taking into account the individualized risks of deleterious radio-induced immune alteration that can be deciphered from the planned beam trajectory through lymphocyte-rich organs. In this review, we critically appraise key aspects to consider while planning immunologically fitted radiotherapy, including the challenges linked to the identification of new dose constraints to immune-rich structures. We also discuss how pharmacologic immunomodulation could be advantageously used in combination with radiotherapy to compensate for the radio-induced loss, for example, with (i) agonists of interleukin (IL)2, IL4, IL7, IL9, IL15, or IL21, similarly to G-CSF being used for the prophylaxis of severe chemo-induced neutropenia, or with (ii) myeloid-derived suppressive cell blockers.
ISSN:1078-0432
1557-3265
DOI:10.1158/1078-0432.CCR-23-3632