Shifting the Immune-Suppressive to Predominant Immune-Stimulatory Radiation Effects by SBRT-PArtial Tumor Irradiation Targeting HYpoxic Segment (SBRT-PATHY)

Tubin, S.; Gupta, Seema; Grusch, Michael; Popper, H.; Brčić, Luka; Ashdown, Martin; Khleif, Samir N.; Peter-Vörösmarty, Barbara; Hyden, Martin; Negrini, Simone; Fossati, Piero; Hug, Eugen B.

doi:10.3390/cancers13010050

Cited by 33 publications

(29 citation statements)

References 78 publications

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“…As a fibric acid derivative displacing oxygen from hemoglobin to hypoxic tissue ultimately leading to an increase of oxygen delivery, efaproxiral exhibited promising results in phase I/II but failed in the later phase of clinical development, especially as a radiosensitiser and hypoxic target therapies [ 374 , 375 , 376 ]. Several additional clinical trials are ongoing with novel radiosensitisers [ 377 , 378 ], and modified radiotherapy protocols according to the hypoxic region to enhance immune cytogenic anti-cancer effect [ 379 , 380 ].…”

Section: Hypoxia-related Treatments and Research Developmentmentioning

confidence: 99%

Hypoxia in Lung Cancer Management: A Translational Approach

Ancel

Perotin

Dewolf

et al. 2021

Cancers

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Lung cancer represents the first cause of death by cancer worldwide and remains a challenging public health issue. Hypoxia, as a relevant biomarker, has raised high expectations for clinical practice. Here, we review clinical and pathological features related to hypoxic lung tumours. Secondly, we expound on the main current techniques to evaluate hypoxic status in NSCLC focusing on positive emission tomography. We present existing alternative experimental approaches such as the examination of circulating markers and highlight the interest in non-invasive markers. Finally, we evaluate the relevance of investigating hypoxia in lung cancer management as a companion biomarker at various lung cancer stages. Hypoxia could support the identification of patients with higher risks of NSCLC. Moreover, the presence of hypoxia in treated tumours could help clinicians predict a worse prognosis for patients with resected NSCLC and may help identify patients who would benefit potentially from adjuvant therapies. Globally, the large quantity of translational data incites experimental and clinical studies to implement the characterisation of hypoxia in clinical NSCLC management.

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Section: Hypoxia-related Treatments and Research Developmentmentioning

confidence: 99%

Hypoxia in Lung Cancer Management: A Translational Approach

Ancel

Perotin

Dewolf

et al. 2021

Cancers

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“…In such critical anatomical sites, safely delivering a high ablative dose in those tumor layers more distantly located from organs at risk while gradually underdosing the successive ones might have a radiobiological rationale in addition to a potentially successful effect. This approach with partial tumor irradiation or with spatially fractionation of the radiation dose is just a hypothesis because it has been effectively tested only for treatment of bulky tumors at different body sites from those examined here [ 64 , 65 ].…”

Section: Discussionmentioning

confidence: 99%

Orbital Metastases: A Systematic Review of Clinical Characteristics, Management Strategies, and Treatment Outcomes

Palmisciano

Ferini²,

Ogasawara

et al. 2021

Cancers

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Background: Orbital metastases often lead to severe functional impairment. The role of resection, orbital exenteration, and complementary treatments is still debated. We systematically reviewed the literature on orbital metastases. Methods: PubMed, Scopus, Web-of-Science, and Cochrane were searched upon PRISMA guidelines to identify studies on orbital metastases. Clinical characteristics, management strategies, and survival were analyzed. Results: We included 262 studies comprising 873 patients. Median age was 59 years. The most frequent primary tumors were breast (36.3%), melanoma (10.1%), and prostate (8.5%) cancers, with median time interval of 12 months (range, 0–420). The most common symptoms were proptosis (52.3%) and relative-afferent-pupillary-defect (38.7%). Most metastases showed a diffuse location within the orbit (19%), with preferential infiltration of orbital soft tissues (40.2%). In 47 cases (5.4%), tumors extended intracranially. Incisional biopsy (63.7%) was preferred over fine-needle aspiration (10.2%), with partial resection (16.6%) preferred over complete (9.5%). Orbital exenteration was pursued in 26 patients (3%). A total of 305 patients (39.4%) received chemotherapy, and 506 (58%) received orbital radiotherapy. Post-treatment symptom improvement was significantly superior after resection (p = 0.005) and orbital radiotherapy (p = 0.032). Mean follow-up was 14.3 months, and median overall survival was 6 months. Fifteen cases (1.7%) demonstrated recurrence with median local control of six months. Overall survival was statistically increased in patients with breast cancer (p < 0.001) and in patients undergoing resection (p = 0.024) but was not correlated with orbital location (p = 0.174), intracranial extension (p = 0.073), biopsy approach (p = 0.344), extent-of-resection (p = 0.429), or orbital exenteration (p = 0.153). Conclusions: Orbital metastases severely impair patient quality of life. Surgical resection safely provides symptom and survival benefit compared to biopsy, while orbital radiotherapy significantly improves symptoms compared to not receiving radiotherapy.

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“…The chosen modality will influence the delivered dose and dose-rate and the nature of the lesions produced in cells. For example SBRT and SRS, which deliver high individual radiation doses with enhanced precision accuracy in only few treatment fractions, can be used to ablate small and well-defined primary tumors anywhere in the body, such as non-small cell lung cancer (NSCLC) (37)(38)(39), or brain metastases (SRS) (40,41). However, these modalities may cause late RIF and RN.…”

Section: Rt Modalities and Differential Effects On Tissuesmentioning

confidence: 99%

Radiation-Induced Immunity and Toxicities: The Versatility of the cGAS-STING Pathway

et al. 2021

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In the past decade, radiation therapy (RT) entered the era of personalized medicine, following the striking improvements in radiation delivery and treatment planning optimization, and in the understanding of the cancer response, including the immunological response. The next challenge is to identify the optimal radiation regimen(s) to induce a clinically relevant anti-tumor immunity response. Organs at risks and the tumor microenvironment (e.g. endothelial cells, macrophages and fibroblasts) often limit the radiation regimen effects due to adverse toxicities. Here, we reviewed how RT can modulate the immune response involved in the tumor control and side effects associated with inflammatory processes. Moreover, we discussed the versatile roles of tumor microenvironment components during RT, how the innate immune sensing of RT-induced genotoxicity, through the cGAS-STING pathway, might link the anti-tumor immune response, radiation-induced necrosis and radiation-induced fibrosis, and how a better understanding of the switch between favorable and deleterious events might help to define innovative approaches to increase RT benefits in patients with cancer.

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Shifting the Immune-Suppressive to Predominant Immune-Stimulatory Radiation Effects by SBRT-PArtial Tumor Irradiation Targeting HYpoxic Segment (SBRT-PATHY)

Cited by 33 publications

References 78 publications

Hypoxia in Lung Cancer Management: A Translational Approach

Hypoxia in Lung Cancer Management: A Translational Approach

Orbital Metastases: A Systematic Review of Clinical Characteristics, Management Strategies, and Treatment Outcomes

Radiation-Induced Immunity and Toxicities: The Versatility of the cGAS-STING Pathway

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