Immunotherapy in Multi-Modal Approach

Posted on: January 21, 2024

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Immunotherapy has emerged as a promising area of cancer treatment that leverages the body’s own immune system to fight cancer cells. Unlike traditional chemotherapy, which often indiscriminately kills both cancerous and normal cells, immunotherapy aims to be more targeted and potentially less toxic. However, immunotherapy isn’t a one-size-fits-all solution, and it doesn’t always work in isolation. For this reason, researchers are increasingly interested in using immunotherapy in combination with other treatment modalities like radiation, surgery, and oncolytic viruses. Here is a brief overview of how immunotherapy can collaborate with these other treatments:

Radiation

• Synergy with Immunotherapy: Radiation kills cancer cells and, in the process, releases tumor antigens that can prime the immune system to recognize and attack cancer cells elsewhere in the body. This makes it a natural candidate for combination with immunotherapies like checkpoint inhibitors.
• Abcoplasty Effect: Some studies suggest that radiation can make tumors more permeable to immune cells, potentially enhancing the effects of immunotherapy.

Surgery

• Pre-operative Immunotherapy: In some cases, immunotherapy is used before surgery to shrink tumors, making them easier to remove.
• Adjuvant Therapy: Post-surgical treatment with immunotherapy may help eradicate any remaining cancer cells and reduce the risk of recurrence.

Oncolytic Viruses

• Double Attack: Oncolytic viruses are engineered to selectively infect and kill cancer cells while sparing normal cells. This can work in concert with immunotherapy, which aims to train the immune system to recognize and kill cancer cells.
• Immune System Activation: The death of cancer cells due to oncolytic viruses can also serve to activate the immune system, providing a one-two punch in combination with immunotherapy.

Challenges and Considerations

• Safety and Toxicity: Combining multiple therapies could lead to unforeseen side effects or toxicities, which requires careful study.
• Optimal Timing and Sequencing: Research is ongoing to determine the best way to sequence these treatments for maximum efficacy.
• Cost: Combining treatments can be expensive, and not all combinations have proven to be more effective than each treatment alone.

Clinical trials are ongoing to better understand how these treatments can best be combined to improve patient outcomes. The hope is that by using a multi-modal approach, it may be possible to treat more types of cancer more effectively.