Immunotherapy and the Interventional Oncologist: Challenges and Opportunities—A Society of Interventional Oncology White Paper

Erinjeri, Joseph P.; Fine, Gerald; Adema, Gosse J.; Ahmed, Muneeb; Chapiro, Julius; Brok, Martijn H. den; Durán, Rafael; Hunt, Stephen; Johnson, David Y.; Ricke, Jens; Sze, Daniel Y.; Toskich, Beau B.; Wood, Bradford J.; Woodrum, David A.; Goldberg, S. Nahum

doi:10.1148/radiol.2019182326

Cited by 62 publications

(51 citation statements)

References 131 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In recent years there has been an increasing wariness that loco-therapies may eliminate not only tumors but also have additional systemic effects ( 16 , 33 ). Some studies described the immunological “abscopal effects” induced by loco-therapies and a range of cytokine and chemokine changed following various ablative procedures, suggesting that once the immune response is triggered the effects could be potentially amplified by immunotherapy ( 16 , 17 , 34 , 35 ). Our study confirmed the hypothesis and found additional ablation enhanced the antitumor effects of anti-PD-1 inhibitors and increased the response rate.…”

Section: Discussionmentioning

confidence: 99%

Ablation Reboots the Response in Advanced Hepatocellular Carcinoma With Stable or Atypical Response During PD-1 Therapy: A Proof-of-Concept Study

Lyu

Kong

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

Background: The anti-programmed cell death protein-1 (PD-1) inhibitor is one of the second-line therapies for advanced hepatocellular carcinoma (HCC) after sorafenib failure. The goal of this study is to evaluate the feasibility and safety of ablation on the tumor in patients with advanced HCC who had stable disease or atypical response during single anti-PD-1 therapy after sorafenib failure. Atypical response defined as mixed responses in different lesions of the same individual (e.g., active or stable lesions mixed with progressive lesions). Patients and Methods: This proof-of-concept clinical trial enrolled 50 patients treated with an anti-PD-1 inhibitor of nivolumab or pembrolizumab monotherapy between July 2015 and Nov 2017. Thirty-three cases with stable disease or atypical response to anti-PD-1 inhibitor received subtotal thermal ablation. The safety and the response of ablation during anti-PD-1 therapy were evaluated. The survival was estimated by the Kaplan-Meier curve. Results: Of all 50 patients treated with anti-PD-1 therapy, the rate of response, stable disease, atypical and typical progression were 10% ( n = 5), 42% ( n = 21) 32% ( n = 16), and 12% ( n = 6), respectively. Additional ablation improved efficacy with tolerable toxicity, and the response rate was increased from 10 to 24% (12/50). The median time to progression, progression-free survival, and overall survival was 6.1 months (95%CI, 2.6–11.2), 5 months (95%CI, 2.9–7.1), and 16.9 months (95%CI, 7.7–26.1), respectively. Conclusions: This proof-of-concept trial suggested that additional ablation may increase the objective response rate with tolerated toxicity and achieved a relatively better median survival, in advanced HCC patients who had stable or atypical progressive diseases during anti-PD-1 therapy, which may provide a potentially promising strategy to treat advanced HCC. Trial registration number: ClinicalTrials.gov identifier: NCT03939975.

show abstract

Section: Discussionmentioning

confidence: 99%

Ablation Reboots the Response in Advanced Hepatocellular Carcinoma With Stable or Atypical Response During PD-1 Therapy: A Proof-of-Concept Study

Lyu

Kong

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Transarterial embolizations in particular may be used to super selectively deliver targeted agents directly into tumors. 55 Both embolizations and ablations also stimulate a modest immune response that is increasingly being investigated as a way to potentially heighten the response to targeted immunotherapeutics 56 (►Fig. 1).…”

Section: Radiomicsmentioning

confidence: 99%

Genomics and Interventional Oncology in Primary Liver Cancer

Slovak

Case

2020

Dig Dis Interv

View full text Add to dashboard Cite

Personalized medicine is revolutionizing oncologic care. Molecular and imaging “fingerprinting” of cancer through genomics, radiomics, and radiogenomics has allowed for the meticulous characterization of many forms of malignancy, including primary liver cancers. With this data, treatments are being developed that precisely target and exploit key variations in individual tumors. As these methods continue to evolve, interventional oncologists are well positioned to capitalize on the advances being made. This article will provide a concise overview of the genomic, radiomic, and radiogenomic research on hepatocellular carcinoma and intrahepatic cholangiocarcinoma, in addition to discussions on how precision medicine would relate to interventional oncology.

show abstract

“…In addition to these preliminary outcome-based studies, there are many important questions to be answered. 94 Most importantly, the timing, sequence, number, and type of combinatory therapy should be determined to optimize the synergistic efficacy.…”

Section: Future Directionsmentioning

confidence: 99%

Postablation Immune Microenvironment: Synergy between Interventional Oncology and Immuno-oncology

Kim

Erinjeri

2019

Semin intervent Radiol

Self Cite

View full text Add to dashboard Cite

Current tumor thermal ablation techniques rely on extreme temperatures to induce irreversible cellular injury and coagulative tissue necrosis. Ablation-induced cellular injury or death releases cancer neoantigens and activates the cancer-immunity cycle, potentially generating tumor-specific immune effectors. However, multiple negative regulatory modulators exist at each step of the cycle, mitigating meaningful and therapeutic anticancer effect provided by the immune system. Recent studies have focused on the introduction and testing of adjuvant immunotherapy combined with ablation to synergistically shift the equilibrium out of inhibitory immune modulation. This article reviews the immune microenvironment in relation to image-guided ablation techniques and discusses current and upcoming novel strategies to take advantage of antitumor immunity.

show abstract

Immunotherapy and the Interventional Oncologist: Challenges and Opportunities—A Society of Interventional Oncology White Paper

Cited by 62 publications

References 131 publications

Ablation Reboots the Response in Advanced Hepatocellular Carcinoma With Stable or Atypical Response During PD-1 Therapy: A Proof-of-Concept Study

Ablation Reboots the Response in Advanced Hepatocellular Carcinoma With Stable or Atypical Response During PD-1 Therapy: A Proof-of-Concept Study

Genomics and Interventional Oncology in Primary Liver Cancer

Postablation Immune Microenvironment: Synergy between Interventional Oncology and Immuno-oncology

Contact Info

Product

Resources

About