Читать книгу Advances in Radiation Therapy - Группа авторов - Страница 22

As immune checkpoint inhibition is the most advanced modality for cancer immunotherapy, the combination with irradiation has been evaluated in a number of preclinical and clinical studies. CTLA-4 blockade showed enhanced local and distant control in combination with irradiation in in vivo models of breast cancer, colorectal cancer, and glioma [67–69]. Similar results have been reported for the combination of radiation with PD-1 blockade [70, 71]. However, the first clinical data showed only limited additive or synergistic activity of combination regimens compared to immune checkpoint inhibition alone in melanoma [72] and prostate cancer [73, 74]. The limited success might be due to the selection of patient cohorts, suboptimal radiation regimes, or problems in timing [75]. In vivo studies also suggest that triple combination of CTLA-4 blockade, PD-1 blockade, and radiation might be able to overcome resistance mechanisms [66]. Ongoing clinical trials in different cancer entities (for example CTLA-4 blockade, summarised by Vanpouille-Box et al. [75]) will show whether and how patients might benefit from combination therapies.