Radioimmunotherapy: future prospects from the perspective of brachytherapy

Abstract

In combination with radiotherapy, immunotherapy is becoming an increasingly used strategy in treating advanced, recurrent, or metastatic cancer. The evident impact of radiotherapy on local and systemic immune response is an indication of the synergistic effect of these two modalities. There is a strong rationale to combine radiotherapy and immunotherapy to enhance response rates and overcome resistances. Therefore, the combination of radio-and immunotherapy holds a variety of opportunities as well as challenges in treating primary cancer and is progressively tested in curative settings. Brachytherapy is also known as internal radiation therapy and only offers a local therapy option at first glance: due to tumor-specific antigens, released by a high local radiation dose, a systemic immune response could be plausible and eminent. Accordingly, brachytherapy could be an underestimated partner with immuno-therapeutic approaches in both curative and palliative settings, to generate local and systemic response. In this review, we summarized the potential benefit of a potential combination of brachytherapy and immuno-therapeutic approaches vs. the background of limited data.

Peripheral blood-based cell signature indicates response to interstitial brachytherapy in primary liver cancer

“…Furthermore, analysis of peripheral blood cells may not only be suitable for general screening of primary liver cancers and therapy response, but may help to gain insight in the functional state of cellular immune responses. Of special interest are immune cells, as irradiation of tumor cells can induce both, immunosuppressive and immunostimulatory effects (Fleischmann et al 2021 ). On the one hand, DNA damage in tumor cells due to ionizing radiation leads to an increase in the overall mutational load.…”

The Lymphatic Endothelium in the Context of Radioimmuno-Oncology

“…Immunotherapy has revolutionized cancer treatment and is considered an integral piece of multimodal therapies [9]. It consists in the (re)awakening of self-defenses against transformed cells (i.e., pressing the gas pedal) or the elimination of the mechanisms that inhibit an adequate response (i.e., releasing the brakes) [10].…”