Dr. Jonathan D. Schoenfeld on Radiation/Immunotherapy Combinations

Jonathan D. Schoenfeld, MD, MPhil, MPH, director, melanoma radiation oncology, physician, assistant professor of radiation oncology, Harvard Medical School, Dana-Farber Cancer Institute, discusses the potential benefit of using radiation and immunotherapy in combination.

There has been an increasing interest in the combination of radiation and immunotherapy, with multiple pre-clinical studies demonstrating that radiation may help immunotherapies work better and vice versa, says Schoenfeld. Because of the pre-clinical data and the number of studies demonstrating promise with this combination, there is an increasing number of clinical trials that are currently testing radiation and immunotherapy together.

One way researchers are testing this combination is by adding immunotherapy where radiation is already standard of care, says Schoenfeld, including in locally advanced head and neck cancer. The addition of immunotherapy, which is already active in the metastatic setting for squamous cell cancers of the head and neck, may improve results in the locally advanced setting.

Other studies are adding radiation in cases where immunotherapy has already become standard of care, says Schoenfeld, like metastatic lung caner, melanoma, and other advanced diseases. There is a lot of interest in adding radiation in these cases because of the abscopal effect, which is a rare clinical phenomenon where patients get radiation in one area but see an impact elsewhere in the body. This is extremely rare, but in pre-clinical models the addition of radiation to immunotherapy makes this effect more common. Radiation could potentially be used as an in situ vaccine to help immunotherapy work better, says Schoenfeld.