Challenges in the combination of radiotherapy and immunotherapy for breast cancer.
Challenges in the combination of radiotherapy and immunotherapy for breast cancer.
复制标题
乳腺癌放射治疗和免疫治疗相结合的挑战。
DOI：
10.1080/14737140.2023.2188196
复制
发表时间：
2023
影响因子：
3.3
通讯作者：
Huang,Weishan
中科院分区：
文献类型：
--
作者：
Zhang,Rui;Clark,SamanthaD;Guo,Beibei;Zhang,Tianyi;Jeansonne,Duane;Jeyaseelan,SamithambyJ;Francis,Joseph;Huang,Weishan
免疫疗法（IT）在乳腺癌的治疗中显示出了希望，但单独使用IT只能使少数患者受益。放射治疗（RT）通常包括在乳腺癌患者的护理标准中，传统上被认为是一种局部治疗形式。RT诱导的全身免疫应答的新知识，以及RT对远处癌症转移的罕见远位效应可以通过IT增强的观察，增加了对乳腺癌患者的组合免疫放射治疗（IRT）的热情。然而，IRT在很大程度上遵循传统的唯一RT和IT协议，并不考虑患者的特异性，虽然患者的反应治疗仍然heterogene.Areas coveredThis审查讨论的基本原理IRT乳腺癌，目前的知识，挑战，和未来的方向。生物标志物的最佳剂量、时机、目标和影响在很大程度上是未知的。目前迫切需要设计有效的临床前和临床试验，以优化癌症患者的IRT，最大限度地发挥辐射和免疫反应的协同作用，并深入探索远位效应，同时考虑患者的个人特征。
IntroductionImmunotherapy (IT) is showing promise in the treatment of breast cancer, but IT alone only benefits a minority of patients. Radiotherapy (RT) is usually included in the standard of care for breast cancer patients and is traditionally considered as a local form of treatment. The emerging knowledge of RT-induced systemic immune response, and the observation that the rare abscopal effect of RT on distant cancer metastases can be augmented by IT, have increased the enthusiasm for combinatorial immunoradiotherapy (IRT) for breast cancer patients. However, IRT largely follows the traditional sole RT and IT protocols and does not consider patient specificity, although patients’ responses to treatment remain heterogeneous.Areas coveredThis review discusses the rationale of IRT for breast cancer, the current knowledge, challenges, and future directions.Expert opinionThe synergy between RT and the immune system has been observed but not well understood at the basic level. The optimal dosages, timing, target, and impact of biomarkers are largely unknown. There is an urgent need to design efficacious pre-clinical and clinical trials to optimize IRT for cancer patients, maximize the synergy of radiation and immune response, and explore the abscopal effect in depth, taking into account patients’ personal features.