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The Abscopal Effect in the Era of Cancer Immunotherapy: a Spontaneous Synergism Boosting Anti-tumor Immunity?

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Abstract

Radiotherapy is one of the main treatment strategies used in cancer. Aside from the local control of the disease, which is mediated by a direct cytotoxic effect on tumor cells, radiotherapy has also been shown to exert immune-mediated local and systemic effects. Radiotherapy can elicit anti-tumor responses in distant sites from the radiation field; this phenomenon is known as the abscopal effect and has been described in patients previously treated with immune checkpoint blockade (ICB). Considering that the efficacy of immunotherapy has been demonstrated only in a subset of patients—who often benefit with lasting responses—efforts are ongoing to potentiate its activity with the development of new combination strategies. Radiotherapy might represent a potential candidate for a synergistic combination with immunotherapy, by improving the immunogenicity of tumors and by enhancing local and systemic immune effects. This review aims to summarize the current pre-clinical and clinical data on the immune effects of radiotherapy and their potential implications for cancer immunotherapy.

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Acknowledgements

We thank David Gray for his writing assistance in the production of the manuscript. Cinzia Solinas and Pushpamali De Silva are fellows of the Belgian Fund for Scientific Research (FNRS)—Operation Télévie.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or non-profit sectors.

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  1. Zuzana Hlavata, Cinzia Solinas and Pushpamali De Silva contributed equally to this work.

Authors and Affiliations

  1. Medical Oncology Department, CHR Mons-Hainaut, Mons, Belgium

    Zuzana Hlavata

  2. Molecular Immunology Unit, Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, Belgium

    Cinzia Solinas, Pushpamali De Silva & Karen Willard-Gallo

  3. Department of Radiology, AOU of Cagliari, SS 554, Monserrato, CA, Italy

    Michele Porcu & Luca Saba

  4. Medical Oncology Department, AOU of Cagliari, SS 554, Monserrato, CA, Italy

    Mario Scartozzi

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  1. Zuzana Hlavata
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Contributions

ZH, CS, and PDS carried out the bibliographic research and take responsibility for the data accuracy. All other authors drafted and wrote the manuscript, participated in the interpretation of the data, and revised the work critically for important intellectual content. All the authors read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work to ensure its accuracy and integrity. MS coordinated and supervised the whole process and gave final approval for manuscript submission.

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Correspondence to Cinzia Solinas.

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Hlavata, Z., Solinas, C., De Silva, P. et al. The Abscopal Effect in the Era of Cancer Immunotherapy: a Spontaneous Synergism Boosting Anti-tumor Immunity?. Targ Oncol 13, 113–123 (2018). https://doi.org/10.1007/s11523-018-0556-3

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