Immune System Activation in Patients with Metastatic Renal Cell Carcinoma Induced by the Systemic Abscopal Effects of Radiation Therapy.

IF 2 4区 医学 Q3 ONCOLOGY Oncology Research and Treatment Pub Date : 2023-01-01 DOI:10.1159/000527959
Mark A D'Andrea, G Kesava Reddy
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引用次数: 1

Abstract

Introduction: Renal cell carcinoma (RCC) is characterized by large histopathologic heterogeneity and classified with multiple histological subtypes. Radiation therapy has long played a key role in the management of both local and metastatic RCC. An out-of-field tumor regression (abscopal response) effect of radiation therapy has gained significant importance in the treatment of different tumor types including RCC. In this study, we provide a detailed overview of the current state of knowledge and clinical experience of radiation therapy-induced abscopal effects in patients with advanced RCC.

Methods: The PRISMA guidelines were followed to identify the published articles for the study. Using electronic databases such as MEDLINE via PubMed and Google Scholar, a systematic literature review was performed to find published clinical evidence for radiation therapy-induced abscopal effects in patients with advanced RCC. The clinical data of radiation therapy-induced abscopal effects were reviewed, and the outcomes have been summarized.

Results: In this study, we evaluated peer-reviewed published reports to find clinical evidence for the abscopal effect following radiation therapy in patients with advanced RCC. The clinical data on the systemic abscopal effects of radiation therapy were reviewed, and the outcomes were summarized. Our literature search indicated that the evidence for abscopal effects of radiation therapy in advanced RCC yielded over 20 case reports. The evidence indicates that abscopal effects of local radiation therapy may occur in RCC through tumor cell destruction with the subsequent release of tumor antigens that systemically stimulate the immune system of the host to activate the body's immune effector cells and produce distant nontarget antitumor effects. The activation of the immune system by local radiation therapy forms the basis to combine immunotherapy to boost its abscopal effects.

Conclusions: Collectively, these findings suggest that radiation therapy can induce systemic abscopal effects through immune system activation, and thus, the addition of immunotherapeutic agents increases the potential to boost the systemic abscopal responses in patients with advanced cancers including RCC.

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放射治疗系统性抽离效应诱导转移性肾癌患者免疫系统激活
肾细胞癌(RCC)具有很大的组织病理学异质性,并分为多个组织学亚型。长期以来,放射治疗在局部和转移性肾细胞癌的治疗中起着关键作用。放射治疗的场外肿瘤消退(抽象反应)效应在包括RCC在内的不同类型肿瘤的治疗中具有重要意义。在这项研究中,我们提供了一个详细的概述,目前的知识和临床经验,放射治疗引起的肾癌晚期患者的体外效应。方法:按照PRISMA指南筛选已发表的研究文章。通过PubMed和Google Scholar的MEDLINE等电子数据库,进行了系统的文献综述,以寻找晚期RCC患者放射治疗诱导的体外效应的已发表的临床证据。本文回顾了近年来放射治疗引起的异位效应的临床资料,并对其结果进行了总结。结果:在这项研究中,我们评估了同行评议的已发表的报告,以寻找晚期RCC患者放射治疗后体外效应的临床证据。本文回顾了近年来有关放射治疗全身外显效应的临床资料,并对其结果进行了总结。我们的文献检索表明,放射治疗对晚期RCC的影响超过20例。有证据表明,局部放射治疗在RCC中可能通过破坏肿瘤细胞,随后释放肿瘤抗原,系统性地刺激宿主免疫系统,激活机体的免疫效应细胞,产生远端非靶向抗肿瘤作用。局部放射治疗对免疫系统的激活构成了结合免疫治疗以增强其体外效果的基础。结论:总的来说,这些发现表明放射治疗可以通过免疫系统激活诱导全身抽离效应,因此,免疫治疗剂的加入增加了包括RCC在内的晚期癌症患者全身抽离反应的潜力。
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
84
期刊介绍: With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.
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