Combining Radiotherapy and Immunotherapy in Metastatic Breast Cancer: Current Status and Future Directions
Details
Publication Year 2022-03-31,Volume 10,Issue #4,Page 821
Journal Title
Biomedicines
Publication Type
Review
Abstract
The role of radiotherapy and immunotherapy with immune checkpoint inhibitors (ICI) is of emerging interest in many solid tumours, including breast cancer. There is increasing evidence that the host's immune system plays an important role in influencing the response to treatment and prognosis in breast cancer. Several pre-clinical studies and clinical trials have reported on the 'abscopal effect-regression of distant untreated tumour sites, mediated by an immunological response following ionizing radiation to a targeted tumour site. Stereotactic Ablative Body Radiotherapy (SABR) is a non-invasive technique used to augment various immune responses with an ablative tumoricidal dose when compared to conventional radiotherapy. SABR is characterized by typically 1-5 precision radiotherapy treatments that simultaneously deliver a high dose, whilst sparing normal tissues. Following SABR, there is evidence of systemic immune activation in patients with increased PD1 expression on CD8(+) and CD4(+) T cells. Studies continue to focus on metastatic triple-negative disease, a highly immunogenic subtype of breast cancer with poor prognosis. In this review, we discuss the immunological effect of SABR, alone and in combination with immunotherapy, and the importance of dose and fractionation. We also propose future strategies for treating oligometastatic disease, where this approach may be most useful for producing durable responses.
Keywords
Sabr; breast cancer; immuno-oncology; immunotherapy; stereotactic radiotherapy
Department(s)
Radiation Oncology; Medical Oncology; Laboratory Research
PubMed ID
35453571
Open Access at Publisher's Site
https://doi.org/10.3390/biomedicines10040821
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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