Immunotherapy and Radiotherapy: New Strategies

Ionizing radiation is a local therapeutic intervention that plays a role in the multipronged approach to the treatment of non-small cell lung cancer. Case reports of excellent clinical responses in patients treated with both checkpoint inhibition and radiation point to a synergy between these two modalities that may extend the reach of radiotherapy from a local to a systemic treatment. Radiotherapy has been referred to as an in situ vaccine, given that its application has the potential to liberate tumor antigen in the context of pro-inflammatory cell death. This chapter describes interactions between radiotherapy and the immune system, with a particular focus on an emerging mechanistic understanding of how radiation can materially contribute to an anti-tumor immune response.