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Nguyen TT, Nguyen TTD, Ta QTH, Vo VG. Advances in non and minimal-invasive transcutaneous delivery of immunotherapy for cancer treatment. Biomed Pharmacother 2020; 131:110753. [PMID: 33152919 DOI: 10.1016/j.biopha.2020.110753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/20/2022] Open
Abstract
Cancer research has focused on figuring out what was the difference between cancer cells and the tissues within which cancer arose and developing targeted treatments for those differences. With FDA-approved treatments for more ten different cancers and more than thousand new clinical trials, immunotherapy has recently emerged as the most promising area of cancer research by improving efficacy and controlling the adverse effects. Transcutaneous delivery drug delivery offers a number of advantages for the patient because of not only its noninvasive and convenient nature but also factors such as avoidance of first-pass metabolism and prevention of gastrointestinal degradation. The purpose of this review was to highlight technological recent approaches to non and minimal-invasive delivery of immunotherapy for cancer treatment. Finally, some practical considerations and discussions for future studies in the field of transdermal immunomodulation are also included.
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Affiliation(s)
- Thuy Trang Nguyen
- Faculty of Pharmacy, Ho Chi Minh City University of Technology (HUTECH), Ho Chi Minh City 700000, Viet Nam
| | - Thi Thuy Dung Nguyen
- Faculty of Environmental and Food Engineering, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Viet Nam
| | - Qui Thanh Hoai Ta
- Institute of Research and Development, Duy Tan University, Danang 550000, Viet Nam
| | - Van Giau Vo
- Bionanotechnology Research Group, Ton Duc Thang University, Ho Chi Minh City 700000, Viet Nam; Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 700000, Viet Nam.
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Daro-Faye M, Kassouf W, Souhami L, Marcq G, Cury F, Niazi T, Sargos P. Combined radiotherapy and immunotherapy in urothelial bladder cancer: harnessing the full potential of the anti-tumor immune response. World J Urol 2020; 39:1331-1343. [PMID: 32915313 PMCID: PMC7484608 DOI: 10.1007/s00345-020-03440-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/03/2020] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Radiotherapy (RT), as part of trimodal therapy, is an attractive alternative treatment in patients with urothelial muscle-invasive bladder cancer (MIBC). There is accumulating evidence suggesting the immunomodulatory effects of RT and its potential synergy when combined with immunotherapy. The aim of this review was to report on the most recent advances on this combination, including the mechanisms of RT immunomodulation, practical approach to combining RT and immunotherapy, and ongoing clinical trials in bladder cancer. METHODS Using the PubMed database, we identified articles published between March 2004 and April 2020 on the combination of RT with immunotherapy in localized or metastatic MIBC. A search of the Clinicaltrials.gov and Clinicaltrialsregister.eu/ retrieved ongoing clinical trials on the topic as well. RESULTS Combination of RT with immunotherapy leads to immunogenic cell death and an increase in immune markers thus leading to improved tumor control. For localized MIBC, there are safety concerns related to the use of concurrent immunotherapy with hypofractionated RT, thus neoadjuvant or adjuvant immunotherapy is preferred. In the metastatic setting, the combination of multi-site RT with SBRT-like doses (≥ 6 Gy per fraction) and concurrent immunotherapy seems most efficacious at harnessing the abscopal effect. At least 25 clinical trials combining immunotherapy and RT in MIBC are currently ongoing and will answer pending questions on safety, efficacy, and practical considerations on RT scheduling, fractionation, and targets volumes. CONCLUSION RT has the potential to synergize with immunotherapy to improve oncological outcomes in patient with localized or metastatic MIBC. Clinical trials results are eagerly awaited.
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Affiliation(s)
- Mame Daro-Faye
- Department of Radiation Oncology, McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Wassim Kassouf
- Department of Urology, McGill University Health Center, Montreal, QC, Canada
| | - Luis Souhami
- Fellow of the American Society for Radiation Oncology (FASTRO), Department of Radiation Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Gautier Marcq
- Department of Urology, McGill University Health Center, Montreal, QC, Canada.,Univ. Lille, Inserm, CHU Lille, U1189-ONCO-THAI-Laser Assisted Therapies and Immunotherapies for Oncology, 59000, Lille, France.,Department of Urology, Claude Huriez Hospital, CHU Lille, 59000, Lille, France
| | - Fabio Cury
- Fellow of the American Society for Radiation Oncology (FASTRO), Department of Radiation Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Tamim Niazi
- Department of Radiation Oncology, Jewish General Hospital, Montreal, QC, Canada
| | - Paul Sargos
- Department of Radiation Oncology, Jewish General Hospital, Montreal, QC, Canada. .,Department of Radiation Oncology, Comprehensive Cancer Center, Institut Bergonie, 33076, Bordeaux Cedex, France.
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Abstract
PURPOSE OF REVIEW Radiotherapy has the potential to augment the host's immune response to cancer. Urological malignancies are highly immunogenic and the combination of radiotherapy and immunotherapy shows promise. In this review, we discuss the effects of radiotherapy on the cancer immune system and highlight the rationale for using the combined approach in prostate, urothelial and renal cancers. Current clinical studies are summarized emphasising the synergistic effects of the combination and the possibility of improved clinical outcomes. RECENT FINDINGS Local and abscopal effects have been observed in different urological cancers when using a combined approach. Large fraction size is associated with an increased immune response. Multiple radiotherapy/immunotherapy combinations are being studied in several clinical trials although no combination has yet been introduced in to standard practice. SUMMARY Although our knowledge of immunomodulation by radiotherapy has improved significantly in recent times, there remain several unanswered questions regarding how to best use the combination in clinical practice. Ongoing trials will provide further insight into complex mechanisms governing radiotherapy-immunotherapy interactions, with potential to improve clinical outcomes.
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Salama AKS, Postow MA, Salama JK. Irradiation and immunotherapy: From concept to the clinic. Cancer 2016; 122:1659-71. [DOI: 10.1002/cncr.29889] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/11/2015] [Accepted: 12/16/2015] [Indexed: 12/13/2022]
Affiliation(s)
- April K. S. Salama
- Division of Medical Oncology, Department of Medicine; Duke University; Durham North Carolina
| | - Michael A. Postow
- Memorial Sloan Kettering Cancer Center; New York New York
- Weill Cornell Medical College; New York New York
| | - Joseph K. Salama
- Department of Radiation Oncology; Duke University; Durham North Carolina
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Barker HE, Paget JTE, Khan AA, Harrington KJ. The tumour microenvironment after radiotherapy: mechanisms of resistance and recurrence. Nat Rev Cancer 2015; 15:409-25. [PMID: 26105538 PMCID: PMC4896389 DOI: 10.1038/nrc3958] [Citation(s) in RCA: 1304] [Impact Index Per Article: 144.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Radiotherapy plays a central part in curing cancer. For decades, most research on improving treatment outcomes has focused on modulating radiation-induced biological effects on cancer cells. Recently, we have better understood that components within the tumour microenvironment have pivotal roles in determining treatment outcomes. In this Review, we describe vascular, stromal and immunological changes that are induced in the tumour microenvironment by irradiation and discuss how these changes may promote radioresistance and tumour recurrence. We also highlight how this knowledge is guiding the development of new treatment paradigms in which biologically targeted agents will be combined with radiotherapy.
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Affiliation(s)
- Holly E. Barker
- Targeted Therapy Team, The Institute of Cancer Research, London, SW3 6JB, UK
| | - James T. E. Paget
- Targeted Therapy Team, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Aadil A. Khan
- Targeted Therapy Team, The Institute of Cancer Research, London, SW3 6JB, UK
| | - Kevin J. Harrington
- Targeted Therapy Team, The Institute of Cancer Research, London, SW3 6JB, UK
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