Over the last two decades, radiation therapy (RT) has been acknowledged to convey immunogenicity to an irradiated neoplastic lesion by eliciting pro-inflammatory signals capable to stimulate the immune system. The ability of RT to trigger systemic anti-tumor immunity provides an explanation for the rare but well-established observation of patients experiencing responses in metastatic sites outside of the irradiated field (so-called abscopal effect). Consequently, a widespread interest into harnessing the local and systemic effects of RT with modern immunotherapy (IT) has spread in clinic with a large increase of clinical trials assessing IT-RT combinations. The design of these clinical trials in terms of IT sequence and RT schedule is rooted on murine experimental findings which have demonstrated the synergy between IT and RT. However, the optimal sequence, radiation dose and fractionation regimen are currently being debated. Reason for such conflicting observations presumably rely on several factors, including (but not limited to) the immune landscape of the tumor prior RT, the intrinsic biology of the tumor and the immunosuppressive signals that can also be elicited by RT. Consequently, translation of preclinical findings is complex, calling for a better understanding on how RT and IT can be optimally combined.This session will provide attendees the opportunity to gain exposure to the latest advances in immuno-radiation. They will be able to determine the pros and cons of ionizing radiations in modulating the immune system, discuss clinical trial design for RT and IO combination and gain insight of potential biomarkers in immunotherapy and radiation oncology.
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