Radiotherapy in the Era of Immunotherapy With a Focus on Non-Small-Cell Lung Cancer: Time to Revisit Ancient Dogmas?
abscopal effect
adscopal effect
immune check point inhibitors (ICI)
immunotherapy
lymphopenia
non-small-cell lung cancer (NSCLC)
radiotherapy
Journal
Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867
Informations de publication
Date de publication:
2021
2021
Historique:
received:
31
01
2021
accepted:
23
03
2021
entrez:
10
5
2021
pubmed:
11
5
2021
medline:
11
5
2021
Statut:
epublish
Résumé
Radiation-induced immune effects have been extensively deciphered over the last few years, leading to the concept of the dual immune effect of radiotherapy with both immunostimulatory and immunosuppressive effects. This explains why radiotherapy alone is not able to drive a strong anti-tumor immune response in most cases, hence underlining the rationale for combining both radiotherapy and immunotherapy. This association has generated considerable interest and hundreds of trials are currently ongoing to assess such an association in oncology. However, while some trials have provided unprecedented results or shown much promise, many hopes have been dashed. Questions remain, therefore, as to how to optimize the combination of these treatment modalities. This narrative review aims at revisiting the old, well-established concepts of radiotherapy relating to dose, fractionation, target volumes and organs at risk in the era of immunotherapy. We then propose potential innovative approaches to be further assessed when considering a radio-immunotherapy association, especially in the field of non-small-cell lung cancer (NSCLC). We finally propose a framework to optimize the association, with pragmatic approaches depending on the stage of the disease.
Identifiants
pubmed: 33968769
doi: 10.3389/fonc.2021.662236
pmc: PMC8097090
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
662236Informations de copyright
Copyright © 2021 Khalifa, Mazieres, Gomez-Roca, Ayyoub and Moyal.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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