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[Abscopal effect: Myth or reality?]

C Mirjolet1, G Truc2

  • 1Department of radiation oncology, Unicancer - Georges-Francois-Leclerc Cancer Center, 21000 Dijon, France; Inserm UMR 1231, 21000 Dijon, France.

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique
|August 31, 2021
PubMed
Summary
This summary is machine-generated.

The abscopal effect, a radiotherapy-induced immune response, shows promise for cancer treatment. Optimizing radiation dose, targets, and immunotherapy combinations is key to harnessing its systemic therapeutic potential.

Keywords:
Abscopal effectsEffet abscopalImmune responseImmunotherapyImmunothérapieRadiotherapyRadiothérapieRéponse immunitaire

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Area of Science:

  • Immunology
  • Radiation Oncology
  • Medical Oncology

Background:

  • The abscopal effect, a distant tumor regression following localized radiotherapy, has been recognized since 1953.
  • Advances in immunology and immunotherapy have renewed interest in its therapeutic potential.
  • While radiotherapy's immune-stimulating effects are known, demonstrating systemic impact and clinical validation remain challenging.

Purpose of the Study:

  • To explore the potential of the abscopal effect as a cancer therapy.
  • To review factors influencing the abscopal effect and its synergy with immunotherapy.
  • To discuss optimal strategies for combining radiotherapy and immunotherapy for metastatic patients.

Main Methods:

  • Review of preclinical and clinical data on the abscopal effect.
  • Analysis of radiotherapy parameters (dose fractionation, target selection, volume) influencing immune response.
  • Evaluation of immunotherapy combinations and scheduling with radiotherapy.

Main Results:

  • Radiotherapy can induce an immune response, but often has immunosuppressive effects limiting distant tumor control.
  • Hypofractionated stereotactic radiotherapy and irradiation of immunogenic tumor sites (liver, lung) may enhance the abscopal effect.
  • Synergy observed between radiotherapy and immunotherapies targeting immunosuppressive mechanisms.

Conclusions:

  • Optimizing radiotherapy techniques, dose fractionation, and target selection is crucial for inducing the abscopal effect.
  • Further research is needed to define optimal immunotherapy combinations, scheduling, and assess radiation-induced lymphopenia.
  • Harnessing the abscopal effect through combined radiotherapy and immunotherapy holds promise for improving outcomes in metastatic cancer patients.