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Radiobiology of Tumours
Published in W. P. M. Mayles, A. E. Nahum, J.-C. Rosenwald, Handbook of Radiotherapy Physics, 2021
Gordon Steel, Catharine West, Alan Nahum
It is, however, unlikely to be always necessary to eradicate the last clonogenic tumour cell to achieve local tumour control.* Radiation can activate immune responses by enhancing antigen presentation and tumour immunogenicity, and increasing the production of cytokines (Bernstein et al. 2016). Localised radiation to tumours can lead to systemic responses at distant sites, a phenomenon known as the abscopal effect (Golden et al. 2015). There is a need to understand how radiation dose and schedule affects immune response mechanisms in preclinical studies and apply new knowledge in the clinic to improve patient outcomes. In 2011, it was stated that ‘cancer immunotherapy comes of age' (Mellman et al. 2011), and combining it with radiotherapy is a current ‘hot' topic in radiation research.
Radiation Dermatitis
Published in Gabriella Fabbrocini, Mario E. Lacouture, Antonella Tosti, Dermatologic Reactions to Cancer Therapies, 2019
John David Strickley, Jae Yeon Jung
Possession of an unpaired electron causes molecules to undergo deleterious transmutations in an effort to establish stability. In the case of DNA, these transmutations can lead to strand breakage, nucleotide loss, nucleotide dimerization, and more (3). Mitotic catastrophe, apoptosis, necrosis, and senescence are all common modes of cell death following radiation (6). In some cases, radiation-induced cell death leads to an antitumor immune response. This phenomenon, called the abscopal effect, results in regression of untreated metastases and may be enhanced by immunomodulating cancer therapies (e.g., ipilimumab) (7).
Developing Technologies for Small Animal Radiotherapy
Published in George C. Kagadis, Nancy L. Ford, Dimitrios N. Karnabatidis, George K. Loudos, Handbook of Small Animal Imaging, 2018
Frank Verhaegen, James Stewart, David Jaffray
Another application for this new technology is the radiation bystander or “abscopal” effect (Mothersill and Seymour 2001; Kaminski et al. 2005) and the related clinical translation of spatially fractionated or “grid” radiotherapy (Penagaricano et al. 2010). The technology provides the capability to irradiate small subregions of tissue, potentially with sharp beam edges, and is therefore ideal for studying these phenomena in vivo.
Magic bubbles: utilizing histotripsy to modulate the tumor microenvironment and improve systemic anti-tumor immune responses
Published in International Journal of Hyperthermia, 2023
Khan M. Imran, Anutosh Ganguly, Tamalika Paul, Manali Powar, Eli Vlaisavljevich, Clifford S. Cho, Irving C. Allen
Intriguingly, in 2 of the 8 patients treated, a significant reduction in the volume of the nontreated tumor lesions in the liver were also observed suggesting a histotripsy mediated abscopal effect [53]. The abscopal effect is a hypothesized systemic anti-tumor immune response induced by various tumor ablation modalities. This effect has been observed in various pre-clinical animal models and sporadically observed in human patients with a number of cancer types. Here, we review the ability of histotripsy to [1] shift the local anti-inflammatory tumor microenvironment from immunologically cold to immunologically hot [2]; enhance innate immune signaling and recognition of damage associated molecular patterns (DAMPs); and [3] improve systemic anti-tumor adaptive immune system activation in a variety of cancers. Together, each of these functions converge and ultimately contribute to both local and systemic anti-tumor immune responses that are predicted to improve patient outcomes.
Challenges in the combination of radiotherapy and immunotherapy for breast cancer
Published in Expert Review of Anticancer Therapy, 2023
Rui Zhang, Samantha D Clark, Beibei Guo, Tianyi Zhang, Duane Jeansonne, Samithamby J Jeyaseelan, Joseph Francis, Weishan Huang
The abscopal effect, which describes the anticancer effect on tumor cells located distant from the locally treated site, was originally described by Mole in 1953 for radiation [38], but this concept has been expanded nowadays because literature shows other local therapies can also cause abscopal effect [39–41]. The abscopal effect has been reported for various cancers including breast cancer over the years [42]. Considering that the majority of deaths due to breast cancer are a consequence of metastatic disease [1,43], the abscopal effect may effectively suppress or eliminate the distant cancer cells and significantly benefit breast cancer patients. However, the abscopal effect arising from RT alone is exceedingly rare, and only 46 cases were reported between 1969 and 2014 [44]. Pre-clinical studies show the abscopal effect is mediated by the immune system [45,46]. Although RT can promote proliferation and priming of T cells, the concentration of fully functional T cells induced by radiation alone is usually not sufficient to elicit an antitumor immunity due to the immunosuppressive tumor microenvironment associated with established tumors, which partially explains the rarity of abscopal effects caused by RT alone.
Overview of the synergistic use of radiotherapy and immunotherapy in cancer treatment: current challenges and scopes of improvement
Published in Expert Review of Anticancer Therapy, 2023
Riccardo Ray Colciago, Irene Fischetti, Carlotta Giandini, Eliana La Rocca, Tiziana Rancati T., Alicia Rejas Mateo, Mario Paolo Colombo, Laura Lozza, Claudia Chiodoni, Elena Jachetti, Maria Carmen De Santis
Abscopal is a word created by joining the prefix ab-, meaning ‘position away from’ and scopus (Latin), meaning ‘mark or target for shooting at’ [20]. Therefore, in oncology, ‘ab-scopal’ means ‘at a distance from the irradiated volume but within the same organism.’ In other words, abscopal effect reflects the complete response of unirradiated metastatic lesions at a distance from the primary irradiation site, mediated by a systemic anti-tumor immune response [20]. The National Cancer Institute defines abscopal effect as: ‘The shrinking or disappearance of tumours in parts of the body that were not the direct targets of local therapy, such as radiation therapy. It is considered that in abscopal effect, the immune system is stimulated to fight cancer in the whole body as a result of local therapy’ [21].