Opinion | Published:

Using immunotherapy to boost the abscopal effect

Nature Reviews Cancer volume 18, pages 313322 (2018) | Download Citation

Abstract

More than 60 years ago, the effect whereby radiotherapy at one site may lead to regression of metastatic cancer at distant sites that are not irradiated was described and called the abscopal effect (from 'ab scopus', that is, away from the target). The abscopal effect has been connected to mechanisms involving the immune system. However, the effect is rare because at the time of treatment, established immune-tolerance mechanisms may hamper the development of sufficiently robust abscopal responses. Today, the growing consensus is that combining radiotherapy with immunotherapy provides an opportunity to boost abscopal response rates, extending the use of radiotherapy to treatment of both local and metastatic disease. In this Opinion article, we review evidence for this growing consensus and highlight emerging limitations to boosting the abscopal effect using immunotherapy. This is followed by a perspective on current and potential cross-disciplinary approaches, including the use of smart materials to address these limitations.

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Acknowledgements

This work was supported by funding from the Brigham and Women's Hospital (BWH) Biomedical Research Institute and the US National Institutes of Health (NIH) grant CA205094-01A1.

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Affiliations

  1. Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School, 450 Brookline Avenue, Boston, MA, USA.

    • Wilfred Ngwa
    • , Omoruyi Credit Irabor
    •  & Jonathan D. Schoenfeld
  2. University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3. D-68167, Mannheim, Germany.

    • Jürgen Hesser
  3. Department of Radiation Oncology, Weill Cornell Medicine, 1300 York Avenue, Box 169, New York, NY, USA.

    • Sandra Demaria
    •  & Silvia C. Formenti

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Contributions

W.N. researched data for the article, made substantial contributions to discussions of the content and wrote the article. O.C.I. researched data for the article, wrote the article and reviewed and/or edited the manuscript before submission. J.D.S., J.H., S.D. and S.C.F. made substantial contributions to discussions of the content and reviewed and/or edited the manuscript before submission.

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The authors declare no competing financial interests.

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Correspondence to Wilfred Ngwa.

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https://doi.org/10.1038/nrc.2018.6