Journal Article

Combining Radiotherapy With Anti-angiogenic Therapy and Immunotherapy; A Therapeutic Triad for Cancer?

Goedegebuure, Ruben S. A., Derks, Sarah, de Klerk, Leonie K., Bass, Adam J., Thijssen, Victor L. J. L.

2019

Overview

Radiotherapy has been used for the treatment of cancer for over a century. Throughout this period, the therapeutic benefit of radiotherapy has continuously progressed due to technical developments and increased insight in the biological mechanisms underlying the cellular responses to irradiation. In order to further improve radiotherapy efficacy, there is a mounting interest in combining radiotherapy with other forms of therapy such as anti-angiogenic therapy or immunotherapy. These strategies provide different opportunities and challenges, especially with regard to dose scheduling and timing. Addressing these issues requires insight in the interaction between the different treatment modalities. In the current review, we describe the basic principles of the effects of radiotherapy on tumor vascularization and tumor immunity and vice versa. We discuss the main strategies to combine these treatment modalities and the hurdles that have to be overcome in order to maximize therapeutic effectivity. Finally, we evaluate the outstanding questions and present future prospects of a therapeutic triad for cancer.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: Angiogenesis / Angiogenesis Inhibitors - pharmacology / Angiogenesis Inhibitors - therapeutic use / Antineoplastic Agents, Immunological - pharmacology / Antineoplastic Agents, Immunological - therapeutic use / Antineoplastic Combined Chemotherapy Protocols - pharmacology / Antineoplastic Combined Chemotherapy Protocols - therapeutic use / Apoptosis / Blood / Cancer / Cancer therapies / Cell cycle / Cell death / Cervical cancer / Chemoradiotherapy - methods / clinical trials / combination treatment / Costimulatory and Inhibitory T-Cell Receptors - antagonists & inhibitors / Costimulatory and Inhibitory T-Cell Receptors - immunology / DNA damage / Humans / Hypoxia / immune response / Immunology / Immunotherapy / Neoplasms - blood supply / Neoplasms - immunology / Neoplasms - therapy / Neovascularization, Pathologic - immunology / Neovascularization, Pathologic - therapy / radiation / Radiation therapy / Randomized Controlled Trials as Topic / Scheduling / therapy / Treatment Outcome / Tumor Microenvironment - drug effects / Tumor Microenvironment - immunology / Tumor Microenvironment - radiation effects / Tumors / Vascularization