Inflammatory microenvironment remodelling by tumour cells after radiotherapy
Top Cited Papers
- 11 March 2020
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Cancer
- Vol. 20 (4), 203-217
- https://doi.org/10.1038/s41568-020-0246-1
Abstract
The development of immune checkpoint inhibitors (ICIs) is revolutionizing the way we think about cancer treatment. Even so, for most types of cancer, only a minority of patients currently benefit from ICI therapies. Intrinsic and acquired resistance to ICIs has focused research towards new combination therapy approaches that seek to increase response rates, the depth of remission and the durability of benefit. In this Review, we describe how radiotherapy, through its immunomodulating effects, represents a promising combination partner with ICIs. We describe how recent research on DNA damage response (DDR) inhibitors in combination with radiotherapy may be used to augment this approach. Radiotherapy can kill cancer cells while simultaneously triggering the release of pro-inflammatory mediators and increasing tumour-infiltrating immune cells – phenomena often described colloquially as turning immunologically ‘cold’ tumours ‘hot’. Here, we focus on new developments illustrating the key role of tumour cell-autonomous signalling after radiotherapy. Radiotherapy-induced tumour cell micronuclei activate cytosolic nucleic acid sensor pathways, such as cyclic GMP–AMP synthase (cGAS)–stimulator of interferon genes (STING), and propagation of the resulting inflammatory signals remodels the immune contexture of the tumour microenvironment. In parallel, radiation can impact immunosurveillance by modulating neoantigen expression. Finally, we highlight how tumour cell-autonomous mechanisms might be exploited by combining DDR inhibitors, ICIs and radiotherapy.Keywords
This publication has 163 references indexed in Scilit:
- Signatures of mutational processes in human cancerNature, 2013
- Treatment-induced damage to the tumor microenvironment promotes prostate cancer therapy resistance through WNT16BNature Medicine, 2012
- STING is a direct innate immune sensor of cyclic di-GMPNature, 2011
- The helicase DDX41 senses intracellular DNA mediated by the adaptor STING in dendritic cellsNature Immunology, 2011
- IFI16 is an innate immune sensor for intracellular DNANature Immunology, 2010
- RNA Polymerase III Detects Cytosolic DNA and Induces Type I Interferons through the RIG-I PathwayCell, 2009
- RIG-I-dependent sensing of poly(dA:dT) through the induction of an RNA polymerase III–transcribed RNA intermediateNature Immunology, 2009
- STING is an endoplasmic reticulum adaptor that facilitates innate immune signallingNature, 2008
- TANK-binding kinase-1 delineates innate and adaptive immune responses to DNA vaccinesNature, 2008
- DAI (DLM-1/ZBP1) is a cytosolic DNA sensor and an activator of innate immune responseNature, 2007