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Updated: Aug 6, 2026

Analysis of Human T Cell Activity in an Allogeneic Co-Culture Setting of Pre-Treated Tumor Cells
Published on: March 7, 2025
Synergistic Mechanisms and Clinical Progress of Radionuclide Therapy Combined with Immune Checkpoint Inhibitors in
Qi Fan1, Zhengwei Fu1, Ming Xu1
1Intestinal Center, Chongqing University Three Gorges Hospital, Chongqing, China.
Abstract:
Background: Radionuclide therapy (RNT) and immune checkpoint inhibitors (ICIs) show mechanistic synergy in colorectal cancer (CRC), but clinical evidence remains limited.Objective: To summarize biological rationale, translational mechanisms, and current clinical evidence supporting RNT-ICI combinations in CRC.Methods: Narrative translational review integrating preclinical studies, radionuclide therapy literature, and CRC radiotherapy-ICI clinical trials.Results: ICIs are effective mainly in MSI-H/dMMR CRC, whereas MSS/pMMR tumors remain resistant. RNT-particularly Y-90 radioembolization-may induce immunogenic cell death, cGAS-STING activation, type I interferon signaling, and stromal remodeling. A pilot clinical study of Y-90 plus dual ICIs demonstrated feasibility and safety but limited efficacy. Evidence from EBRT-ICI CRC studies supports radiation-induced immune priming but is not directly transferable to RNT.Conclusion: RNT-ICI combinations are biologically plausible but not yet clinically validated. Future progress requires biomarker-driven, dosimetry-informed, and liver-dominant trial designs.
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