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Department of Immunology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran , jalalia@sbmu.ac.ir
Abstract:   (597 Views)
Background: Radiotherapy (RT) is an effective treatment in field of cancer. Since the potential effect of RT is heavily dependent on the patient's immune system, using the immunotherapy to enhance the radiotherapy effects seems to be a positive step in cancer treatment.
Materials and Methods: In order to write the present review article, key words including radiotherapy, immunotherapy, combination therapy, and immune-checkpoint inhibitors antibodies were searched in reliable databases, including Google Scholar, PubMed, Scopus, and Elsevier. Among potential candidates, those that were most relevant to the purpose of the study and evaluated the combination of radiotherapy and immunotherapy with immune-checkpoint inhibitors antibodies were selected and utilized.
Results: RT has distinct effects on the tumor microenvironment which can either inhibit or promote tumor growth. RT by inducing immunogenic cell death results in release of danger signals, increase in cytokine/chemokine secretion, recruit T cells and macrophages into tumor microenvironment and activate anti-tumor immunity. On the other hand, RT can stimulate tumor growth through infiltrating inhibitory immune cells such as regulatory T cells and MDSCs into the tumor microenvironment. Also, radiotherapy alters the expression of CTLA-4, PD-1, and PD-L1 molecules on tumor and immune cells. Studies show that the combination of immunotherapy and RT (radio-immunotherapy) induces the synergic effects on stimulation of anti-tumor immune response.
Conclusion: Due to the change in the expression of immune- checkpoint molecules including CTLA-4 and PD-1 on tumor and immune cells, and the impact on anti-tumor immune function in controlling tumor growth as a result of radiotherapy, it seems that a rational solution to overcome the inhibitory effects and enhance the anti-tumor effects of RT is anti-checkpoint antibodies (anti-CTLA-4 and anti-PD-1). However, some factors including dose, type of radiation, and the timing of RT in relation to administration of checkpoint inhibitors are some of challenges along this way.
Key words: Radiotherapy, Immunotherapy, Immune-checkpoint inhibitors, Combination therapy
     
Type of Study: Review | Subject: Immunology
Received: 2020/01/21 | Accepted: 2020/08/25

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