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Tumor microenvironment, immune response and post-radiotherapy tumor clearance

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Abstract

Radiotherapy is the treatment of choice for many cancer patients. Residual tumor leads to local recurrence after a period of an equilibrium created between proliferating, quiescent and dying cancer cells. The tumor microenvironment is a main obstacle for the efficacy of radiotherapy, as impaired blood flow leads to hypoxia, acidity and reduced accessibility of radiosensitizers. Eradication of remnant disease is an intractable clinical quest. After more than a century of research, anti-tumor immunity has gained a dominant position in oncology research and therapy. Immune cells play a significant role in the eradication of tumors during and after the completion of radiotherapy. The tumor equilibrium reached in the irradiated tumor may shift towards cancer cell eradication if the immune response is appropriately modulated. In the modern immunotherapy era, clinical trials are urged to standardize immunotherapy schemes that could be safely applied to improve clearance of the post-radiotherapy remnant disease.

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Funding

The study has been financially supported by the Democritus University of Thrace Special Account, project no 81006.

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  1. Department of Radiotherapy/Oncology, Democritus University of Thrace, 68100, Alexandroupolis, Greece

    M. I. Koukourakis

  2. Department of Pathology, Democritus University of Thrace, 68100, Alexandroupolis, Greece

    A. Giatromanolaki

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MIK: conception and writing of the paper. AG: conception and writing of the paper.

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Correspondence to M. I. Koukourakis.

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The patient CT-scan shown in Fig. 2 has been treated according to a protocol approved by the local Ethics and Scientific Committee (DS34/28-9-2006).

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Koukourakis, M.I., Giatromanolaki, A. Tumor microenvironment, immune response and post-radiotherapy tumor clearance. Clin Transl Oncol 22, 2196–2205 (2020). https://doi.org/10.1007/s12094-020-02378-8

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