ICML 2023 | Re-evaluating the role of radiation therapy in lymphoma & exploring combinations with immunotherapy
Stephen Ansell, MD, PhD, Mayo Clinic, Rochester, MI, briefly discusses the changing role of radiation therapy in lymphoma, emphasizing its impact on the tumor microenvironment. Prof. Ansell also explains how radiation therapy may be combined with immunotherapies including CAR-T cells and bispecifics, providing a novel approach to treat patients. This interview took place at the 17th International Conference on Malignant Lymphoma (ICML), held in Lugano, Switzerland.
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Transcript (edited for clarity)
I think what’s become very interesting is that radiation therapy, which had only a minor role in patients with lymphoma, often really just palliative and focused on specific diseased areas that were a clinical problem. That’s being reimagined because of the role of radiation in potentially changing the tumor microenvironment. Radiation therapy can induce an immunogenic cell death. And so as the cells die, they release a lot of different antigens, and that may make the tumor more visible to the immune system...
I think what’s become very interesting is that radiation therapy, which had only a minor role in patients with lymphoma, often really just palliative and focused on specific diseased areas that were a clinical problem. That’s being reimagined because of the role of radiation in potentially changing the tumor microenvironment. Radiation therapy can induce an immunogenic cell death. And so as the cells die, they release a lot of different antigens, and that may make the tumor more visible to the immune system. The other thing that happens is the radiation may affect a lot of the other cells in the microenvironment, including different cells, neovascularization can be changed, different cells, such as monocytes and macrophages could be changed. So I think radiation oncologists are getting excited about what they could potentially do in conjunction with immunotherapies. So specifically, my contribution to the meeting was to talk about the biology and immunology of the immune response. But the meeting in general was to talk a lot about how radiation therapy can be combined with CAR-T cell therapy, bispecific therapy and other immunological treatments, because I think the radiation may actually contribute in a significant way. So I think that’s another whole area and a whole avenue of treatment that’s being opened up. And the role of radiation therapy, which in the past might have been minor, is now moving kind of more front and center.
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