Abstract
Autophagy is fundamental to the maintenance of intracellular homeostasis in virtually all human cells. Accordingly, defective autophagy predisposes healthy cells to undergoing malignant transformation. By contrast, malignant cells are able to harness autophagy to thrive, despite adverse microenvironmental conditions, and to resist therapeutic challenges. Thus, inhibition of autophagy has been proposed as a strategy to kill cancer cells or sensitize them to therapy; however, autophagy is also critical for optimal immune function, and mediates cell-extrinsic homeostatic effects owing to its central role in danger signalling by neoplastic cells responding to immunogenic chemotherapy and/or radiation therapy. In this Perspective, we discuss accumulating preclinical and clinical evidence in support of the all-too-often dismissed possibility that activating autophagy might be a relevant clinical objective that enables an increase in the effectiveness of immunogenic chemotherapy and/or radiation therapy.
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Acknowledgements
L.G., J.M.B.-S.P. and G.K. gratefully acknowledge financial support from the ANR under the frame of E-Rare-2 (the ERA-Net for Research on Rare Diseases); Cancéropôle Ile-de-France; the European Commission (ArtForce); the European Research Council (ERC); the Fondation Bettencourt Schueller; the Fondation de France; the French Agence National de la Recherche (ANR) — Projets Blancs; the French Association pour la recherche sur le cancer (ARC); the French Fondation pour la Recherche Médicale (FRM); the French Institut National du Cancer (INCa); the French Ligue contre le Cancer (équipe labellisée); the LabEx Immuno-Oncology; the Paris Alliance of Cancer Research Institutes (PACRI); the SIRIC Cancer Research and Personalized Medicine (CARPEM); the SIRIC (Sites de Recherche Intégrée sur le Cancer) Stratified Oncology Cell DNA Repair and Tumour Immune Elimination (SOCRATE); the Swiss Bridge Foundation; and the Swiss Institute for Experimental Cancer Research (ISREC). The work of S.D. is supported by the Breast Cancer Research Foundation, the Chemotherapy Foundation, and the US National Institutes of Health (grants R01 CA201246 and R01 CA198533). The work of S.C.F is supported by the Breast Cancer Research Foundation; the US Department of Defence Breast Cancer Research Program (grant W81XWH-11-1-0530); and the US National Institutes of Health (grant R01 CA161891).
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Galluzzi, L., Bravo-San Pedro, J., Demaria, S. et al. Activating autophagy to potentiate immunogenic chemotherapy and radiation therapy. Nat Rev Clin Oncol 14, 247–258 (2017). https://doi.org/10.1038/nrclinonc.2016.183
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DOI: https://doi.org/10.1038/nrclinonc.2016.183
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