Combining Systemic and Local/Regional Approaches to Improve Immunotherapy Sensitivity

Immune checkpoint inhibition has been combined with various locoregional therapies, including radiation, regional perfusion, and local injections of cytokines, bacteria, and viruses. The goals of combination therapy include improving local response and amplifying systemic immunity. Combination therapy has shown improved local response in multiple settings and systemic responses in patients who were progressing on immunotherapy before the addition of a locoregional therapy. The authors review the evidence for combination therapy and discuss ongoing trials focused on disease settings, where local control has important implications for survival and/or functional outcome.