TY - JOUR
T1 - The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the Field
AU - Miljanic, Mihailo
AU - Montalvo, Steven
AU - Aliru, Maureen
AU - Song, Tidie
AU - Leon-Camarena, Maria
AU - Innella, Kevin
AU - Vujovic, Dragan
AU - Komaki, Ritsuko
AU - Iyengar, Puneeth
N1 - Publisher Copyright:
© 2022 by the authors.
PY - 2022/9
Y1 - 2022/9
N2 - In this commentary, we describe the potential of highly ablative doses utilizing Stereotactic Body Radiation Therapy (SBRT) in single or few fractions to enhance immune-responsiveness, how timing of this approach in combination with immune-checkpoint inhibitors may augment treatment-effect, and whether Personalized Ultrafractionated Stereotactic Adaptive Radiation Therapy (PULSAR) is an avenue for future advancement in the continued endeavor to foster a systemic effect of therapy beyond the radiation treatment field. The ablative potential of SBRT may support an increase in tumor-antigen presentation, enhancement of immune-stimulatory components, and an improvement in tumor-microenvironment immune cell infiltration. Furthermore, the latest advancement of ablative radiation delivery is PULSAR-based therapy, whereby ablative doses are delivered in pulses of treatment that may be several weeks apart, combined with adaptive treatment to tumor changes across time. The benefits of this novel approach include the ability to optimize direct tumor control by assessment of tumor size and location via dedicated imaging acquired prior to each delivered pulse, and further potentiation of immune recognition through combination with concurrent immune-checkpoint blockade.
AB - In this commentary, we describe the potential of highly ablative doses utilizing Stereotactic Body Radiation Therapy (SBRT) in single or few fractions to enhance immune-responsiveness, how timing of this approach in combination with immune-checkpoint inhibitors may augment treatment-effect, and whether Personalized Ultrafractionated Stereotactic Adaptive Radiation Therapy (PULSAR) is an avenue for future advancement in the continued endeavor to foster a systemic effect of therapy beyond the radiation treatment field. The ablative potential of SBRT may support an increase in tumor-antigen presentation, enhancement of immune-stimulatory components, and an improvement in tumor-microenvironment immune cell infiltration. Furthermore, the latest advancement of ablative radiation delivery is PULSAR-based therapy, whereby ablative doses are delivered in pulses of treatment that may be several weeks apart, combined with adaptive treatment to tumor changes across time. The benefits of this novel approach include the ability to optimize direct tumor control by assessment of tumor size and location via dedicated imaging acquired prior to each delivered pulse, and further potentiation of immune recognition through combination with concurrent immune-checkpoint blockade.
KW - PULSAR
KW - SAbR
KW - SBRT
KW - SBRT and immunotherapy
KW - adaptive radiation therapy
KW - immunotherapy in combination with radiation therapy
UR - http://www.scopus.com/inward/record.url?scp=85138675305&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85138675305&partnerID=8YFLogxK
U2 - 10.3390/cancers14184530
DO - 10.3390/cancers14184530
M3 - Comment/debate
C2 - 36139689
AN - SCOPUS:85138675305
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 18
M1 - 4530
ER -