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Combining Radiotherapy and Immunotherapy in Metastatic Breast Cancer: Current Status and Future Directions

The role of radiotherapy and immunotherapy with immune checkpoint inhibitors (ICI) is of emerging interest in many solid tumours, including breast cancer. There is increasing evidence that the host’s immune system plays an important role in influencing the response to treatment and prognosis in brea...

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Autores principales: David, Steven, Tan, Jennifer, Siva, Shankar, Karroum, Lama, Savas, Peter, Loi, Sherene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024725/
https://www.ncbi.nlm.nih.gov/pubmed/35453571
http://dx.doi.org/10.3390/biomedicines10040821
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author David, Steven
Tan, Jennifer
Siva, Shankar
Karroum, Lama
Savas, Peter
Loi, Sherene
author_facet David, Steven
Tan, Jennifer
Siva, Shankar
Karroum, Lama
Savas, Peter
Loi, Sherene
author_sort David, Steven
collection PubMed
description The role of radiotherapy and immunotherapy with immune checkpoint inhibitors (ICI) is of emerging interest in many solid tumours, including breast cancer. There is increasing evidence that the host’s immune system plays an important role in influencing the response to treatment and prognosis in breast cancer. Several pre-clinical studies and clinical trials have reported on the ‘abscopal effect—regression of distant untreated tumour sites, mediated by an immunological response following ionizing radiation to a targeted tumour site. Stereotactic Ablative Body Radiotherapy (SABR) is a non-invasive technique used to augment various immune responses with an ablative tumoricidal dose when compared to conventional radiotherapy. SABR is characterized by typically 1–5 precision radiotherapy treatments that simultaneously deliver a high dose, whilst sparing normal tissues. Following SABR, there is evidence of systemic immune activation in patients with increased PD1 expression on CD8(+) and CD4(+) T cells. Studies continue to focus on metastatic triple-negative disease, a highly immunogenic subtype of breast cancer with poor prognosis. In this review, we discuss the immunological effect of SABR, alone and in combination with immunotherapy, and the importance of dose and fractionation. We also propose future strategies for treating oligometastatic disease, where this approach may be most useful for producing durable responses.
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spelling pubmed-90247252022-04-23 Combining Radiotherapy and Immunotherapy in Metastatic Breast Cancer: Current Status and Future Directions David, Steven Tan, Jennifer Siva, Shankar Karroum, Lama Savas, Peter Loi, Sherene Biomedicines Review The role of radiotherapy and immunotherapy with immune checkpoint inhibitors (ICI) is of emerging interest in many solid tumours, including breast cancer. There is increasing evidence that the host’s immune system plays an important role in influencing the response to treatment and prognosis in breast cancer. Several pre-clinical studies and clinical trials have reported on the ‘abscopal effect—regression of distant untreated tumour sites, mediated by an immunological response following ionizing radiation to a targeted tumour site. Stereotactic Ablative Body Radiotherapy (SABR) is a non-invasive technique used to augment various immune responses with an ablative tumoricidal dose when compared to conventional radiotherapy. SABR is characterized by typically 1–5 precision radiotherapy treatments that simultaneously deliver a high dose, whilst sparing normal tissues. Following SABR, there is evidence of systemic immune activation in patients with increased PD1 expression on CD8(+) and CD4(+) T cells. Studies continue to focus on metastatic triple-negative disease, a highly immunogenic subtype of breast cancer with poor prognosis. In this review, we discuss the immunological effect of SABR, alone and in combination with immunotherapy, and the importance of dose and fractionation. We also propose future strategies for treating oligometastatic disease, where this approach may be most useful for producing durable responses. MDPI 2022-03-31 /pmc/articles/PMC9024725/ /pubmed/35453571 http://dx.doi.org/10.3390/biomedicines10040821 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
David, Steven
Tan, Jennifer
Siva, Shankar
Karroum, Lama
Savas, Peter
Loi, Sherene
Combining Radiotherapy and Immunotherapy in Metastatic Breast Cancer: Current Status and Future Directions
title Combining Radiotherapy and Immunotherapy in Metastatic Breast Cancer: Current Status and Future Directions
title_full Combining Radiotherapy and Immunotherapy in Metastatic Breast Cancer: Current Status and Future Directions
title_fullStr Combining Radiotherapy and Immunotherapy in Metastatic Breast Cancer: Current Status and Future Directions
title_full_unstemmed Combining Radiotherapy and Immunotherapy in Metastatic Breast Cancer: Current Status and Future Directions
title_short Combining Radiotherapy and Immunotherapy in Metastatic Breast Cancer: Current Status and Future Directions
title_sort combining radiotherapy and immunotherapy in metastatic breast cancer: current status and future directions
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024725/
https://www.ncbi.nlm.nih.gov/pubmed/35453571
http://dx.doi.org/10.3390/biomedicines10040821
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