Professor Anthony Chalmers
Chair of Clinical Oncology, The University of Glasgow
Understanding the immune response to radiotherapy will create exciting opportunities to identify novel therapeutic targets and enhance the efficacy of cancer immunotherapy.
Harnessing the immune response to treat cancer is not a new concept. However, recent advances in this area have transformed the treatment of certain cancers, dramatically increasing life expectancy even for patients with metastatic disease.
For many cancer types, immunotherapy has yet to improve outcomes. In contrast, radiotherapy has been the cornerstone of cancer therapy for many decades. It has cured a significant proportion of patients and enhanced quality of life when other treatments have failed.
Integrating novel approaches to maximise patient benefit
Recent innovations in radiotherapy and imaging technologies have massively increased the precision with which radiotherapy can be delivered. This trend is set to continue with the emergence of protons and other advanced radiation modalities.
What happens when we combine advanced radiotherapy techniques with immunotherapy? It depends on the cancer in question, but in some cases radiotherapy appears to stimulate the immune system, encouraging it to attack cancer cells thereby improving responses to immunotherapy.
Strikingly, this stimulatory effect is sometimes seen in distant tumours that did not receive radiotherapy, as well as the irradiated tumour. This ‘abscopal effect’ remains relatively uncommon, however, it is not yet fully understood how radiotherapy overcomes the ability of tumours to suppress the immune system. Complex immunological phenomena such as organ cross-talk and concomitant immunity have recently emerged as possible drivers of the radiation effects.
Radiotherapy can also affect the immune environment of healthy tissues, such as the gut mucosa. Unraveling the mechanisms behind these effects could lead to new therapeutic targets.
It is equally important to note, it may help identify strategies for alleviating the side effects of both radiotherapy and immunotherapy, thus improving patients’ quality of life. The opportunities for scientific discovery at the intersection of these research areas are immense. They have genuine potential to create new and more effective treatment strategies for a broader spectrum of cancer patients.
We need to create an environment that promotes and nurtures interaction between immunologists, cancer researchers and clinicians to facilitate translational research activity.
Collaborating across disciplines
To fully exploit the immune system’s response to radiotherapy and improve patient outcomes it is vital to work across disciplines. We need to create an environment that promotes and nurtures interaction between immunologists, cancer researchers and clinicians to facilitate translational research activity.
The British Society for Immunology and the National Cancer Research Institute have recently partnered on an initiative to maximise collaboration in this area. The ultimate goal is to accelerate translation of cancer-related immunology research into life-saving outcomes for cancer patients.
To find out more about the initiative visit www.ncri.org.uk