Hypothesis review of new cancer treatment: Combination of Radiation Therapy with Immunotherapy

Introduction & Purpose: Radiotherapy has shown its efficacy in eradication tumors in situ, and it has been used for cancer treatment for more than a hundred years. Immunotherapy depends on generating a robust anti-tumor immune response. Radiotherapy can improve the effects of immunotherapy and generate the abscopal effect in certain types of cancers. The study objective is to present the rational basis for this combination, as it will be one of the next promising cancer treatment combinations. Materials & Method: For Non-Small Cell Lung Cancer metastatic melanoma, metastatic Renal Cell Carcinoma, Triple-Negative Breast Cancer; and Head and Neck Squamous Cell Carcinoma, the most important, recent, and published clinical studies are presented and discussed. Discussion: The combination of IT and RT has faced several challenges, such as the optimal dose of radiation, the optimal sequencing with IT, the safety and efficacy of this combination and the finding of universal biomarkers. These challenges are discussed in details Conclusion: Encouraging clinical outcomes were obtained. SBRT can generate anti-tumor immune response. Researchers did not find a significant increase in radiation-induced adverse events, and they did not find that RT increases the risk of immune-related adverse events. Toxic events seem to be acceptable. Finally, performing randomized properly controlled trials assess by a good methodology on a large number of patients is needed to ensure the safety and the efficacy of combining RT with IT.