Some lung cancers do not respond well to immunotherapy, a treatment that helps the body’s immune system attack cancer.
But a new study shows that radiation therapy might help solve this problem.
The research comes from scientists at Johns Hopkins and the Netherlands Cancer Institute. It was supported by the U.S. National Institutes of Health and published in the journal Nature Cancer on July 22.
The researchers studied patients with non-small cell lung cancer, the most common type of lung cancer. They wanted to find out what happens in the body when people get radiation before immunotherapy, compared to those who get only immunotherapy.
They discovered that radiation can help the immune system respond better to cancer. This means tumors that were once resistant to immunotherapy could now become sensitive to it.
The reason this happens is something called the “abscopal effect.” Normally, radiation is used to kill cancer cells in one spot. When this happens, the dying cells release substances into their surroundings.
These substances can help the immune system recognize what the cancer looks like. The immune system then sends fighter cells, called T cells, to attack cancer cells in other parts of the body—even those that weren’t directly treated with radiation.
To understand this process better, the research team collected almost 300 blood and tumor samples from 72 lung cancer patients. Some patients received only immunotherapy, while others got radiation first, followed by immunotherapy using a drug called pembrolizumab.
The researchers used a technique called “multiomic analysis.” This means they looked at many layers of information in the samples, like genes, proteins, and immune cells. They especially focused on tumors that are known to be “cold.”
Cold tumors don’t usually respond to immunotherapy. These tumors tend to have few mutations, low levels of a protein called PD-L1, or changes in a cell pathway called Wnt.
Surprisingly, after patients received radiation followed by immunotherapy, the cold tumors began to “warm up.” This means their surroundings became more active with immune cells. The team found more new and existing T cells in these areas, suggesting that the immune system was now fighting the cancer more effectively.
The researchers also looked closely at the patients who lived longer after receiving this combination treatment. They tested their blood and tumor samples and found that the T cells were able to recognize special markers on the cancer cells. This confirmed that radiation helped the immune system learn to fight the cancer.
When the scientists followed the patients over time, they noticed that those with cold tumors who got radiation had better outcomes than those who didn’t. This shows that radiation can help break through the barrier that keeps some tumors from responding to immunotherapy.
In summary, the study found that radiation can act like a “booster” for the immune system. It can make some hard-to-treat lung cancers respond better to immunotherapy. This gives hope to patients who might not have had success with immunotherapy alone.
The research team continues to study how the body responds to this treatment by tracking cancer DNA in the blood. Their goal is to make cancer treatment more personalized and effective for each patient.
If you care about lung health, please read studies about marijuana’s effects on lung health, and why some non-smokers get lung disease and some heavy smokers do not.
For more information about health, please see recent studies that olive oil may help you live longer, and vitamin D could help lower the risk of autoimmune diseases.
The study findings are published in Nature Cancer.
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