The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the Field
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 whet...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/14/18/4530 |
| _version_ | 1797490226858295296 |
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| author | Mihailo Miljanic Steven Montalvo Maureen Aliru Tidie Song Maria Leon-Camarena Kevin Innella Dragan Vujovic Ritsuko Komaki Puneeth Iyengar |
| author_facet | Mihailo Miljanic Steven Montalvo Maureen Aliru Tidie Song Maria Leon-Camarena Kevin Innella Dragan Vujovic Ritsuko Komaki Puneeth Iyengar |
| author_sort | Mihailo Miljanic |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T00:29:00Z |
| format | Article |
| id | doaj.art-cfd97c33fc60404f959cf2563ba34b7f |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T00:29:00Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-cfd97c33fc60404f959cf2563ba34b7f2023-11-23T15:28:53ZengMDPI AGCancers2072-66942022-09-011418453010.3390/cancers14184530The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the FieldMihailo Miljanic0Steven Montalvo1Maureen Aliru2Tidie Song3Maria Leon-Camarena4Kevin Innella5Dragan Vujovic6Ritsuko Komaki7Puneeth Iyengar8Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USADepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USADepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USADepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USADepartment of Internal Medicine, University of Texas at Austin, Austin, TX 78705, USAPhiladelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USAIcahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, NY 10029, USAEmeritus Professor of Radiation Oncology, UT MDACC, Adjunct Professor of Radiation Oncology Baylor College of Medicine, Houston, TX 77030, USADepartment of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USAIn 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.https://www.mdpi.com/2072-6694/14/18/4530SBRTSAbRPULSARadaptive radiation therapyimmunotherapy in combination with radiation therapySBRT and immunotherapy |
| spellingShingle | Mihailo Miljanic Steven Montalvo Maureen Aliru Tidie Song Maria Leon-Camarena Kevin Innella Dragan Vujovic Ritsuko Komaki Puneeth Iyengar The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the Field Cancers SBRT SAbR PULSAR adaptive radiation therapy immunotherapy in combination with radiation therapy SBRT and immunotherapy |
| title | The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the Field |
| title_full | The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the Field |
| title_fullStr | The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the Field |
| title_full_unstemmed | The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the Field |
| title_short | The Evolving Interplay of SBRT and the Immune System, along with Future Directions in the Field |
| title_sort | evolving interplay of sbrt and the immune system along with future directions in the field |
| topic | SBRT SAbR PULSAR adaptive radiation therapy immunotherapy in combination with radiation therapy SBRT and immunotherapy |
| url | https://www.mdpi.com/2072-6694/14/18/4530 |
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