Combinations of radiotherapy with immunotherapy in nasopharyngeal carcinoma

PTEN as a prognostic factor for radiotherapy plus immunotherapy response in nasopharyngeal carcinoma

BACKGROUND

In the context of nasopharyngeal carcinoma (NPC) treatment, radiotherapy combined with immunotherapy (IR + RT) is gaining traction. This study focuses on analyzing exosomal proteins, particularly Phosphatase and Tensin Homolog (PTEN), for predicting the efficacy of NPC treatments. Serum samples from NPC patients and IR + RT recipients were utilized for exosome (Exo) extraction and subsequent transcriptomic and proteomic analyses to identify treatment-related proteins. Flow cytometry of cells and exosomal analysis were performed to examine these proteins. In vitro experiments using C666-1 cells and their Exos explored various cellular responses, while a murine subcutaneous NPC model investigated the impact of PTEN modulation on tumor growth and the immune microenvironment.

RESULTS

The study demonstrated that PTEN serves as a crucial predictive biomarker, with its expression changes correlated with M2 macrophage polarization and CD8+ T cell activity. This highlights the potential significance of PTEN in predicting treatment outcomes and influencing the immune response in NPC.

CONCLUSION

The findings suggest that PTEN could play a key role in enhancing the efficacy of NPC radiotherapy and immunotherapy. By shedding light on PTEN's impact on tumor growth and the immune microenvironment, this study lays the groundwork for future personalized therapeutic strategies in NPC treatment.

Case Report: Intensity-modulated radiotherapy combined with immunotherapy for intramedullary spinal cord metastases of lung adenocarcinoma

Intramedullary spinal cord metastases (ISCMs) are rare in clinical practice and their presentation is usually an unfavorable sign with a median overall survival (mOS) of 3-4 months after diagnosis. Due to their rarity, heterogeneity and rapid progression, clinicians have few satisfactory guidelines or optimal management for ISCMs. Herein, we share a clinical experience of intensity-modulated radiotherapy (IMRT) combined with immunotherapy (IO) for ISCMs from lung adenocarcinoma (LUAD) that achieved a relatively high quality of life for 10 months, which has not been previously reported.

Combination therapy of low-dose radiotherapy and immunotherapy in advanced metastatic nasopharyngeal carcinoma: a case report and literature review

BACKGROUND

Nasopharyngeal cancer (NPC) is a common head and neck malignant tumor, which is difficult to treat at the advanced NPC due to its occult and high metastatic potential to the cervical lymph nodes and distant organs. Low-dose radiotherapy (LDRT) is increasingly being investigated for potential cancer treatment. When combined with immune checkpoint inhibitors, LDRT has been shown to significantly improve the immune microenvironment of tumors, thereby promote the immune attack on tumor cells. However, the therapeutic effect of LDRT combined with immunotherapy in advanced NPC is not well understood. We report a case of a 31-year-old man was diagnosed with advanced metastatic nasopharnygeal non-keratinizing carcinoma (T4N3M1 stage IVb AJCC8th). The patient was treated with a high-dose of radiation therapy combined with LDRT and immunotherapy to inhibit tumor cell proliferation and activate the body's immune system. The initial treatment procedure was as follows: chemotherapy regimen (nedaplatin + docetaxel + fluorouracil) induction, followed by radical radiotherapy for the primary lesion, LDRT for the L5 vertebral body metastasis, and concurrent use of low-dose capecitabine beat chemotherapy and toripalimab immunotherapy. The patient was also administered with human granulocyte-macrophage colony-stimulating factor and aspirin to enhance the immune function. This combination therapy approach alleviated patient symptoms, improved bone changes in the L5 vertebral body and resolved the tumor without any adverse effects signals. The progression-free survival (PFS) has reached 27 months and he is currently stable without tumor recurrence.

CONCLUSION

The combination of chemotherapy and LDRT with aspirin and human granulocyte macrophage colony-stimulating factor improved the disease state of advanced NPC cancer, effectively reducing the level of tumor markers, enhanced the immune function without significant adverse reactions.

Head and Neck Squamous Cell Carcinoma: Insights from Dual-Energy Computed Tomography (DECT)

Head and neck cancer represents the seventh most common neoplasm worldwide, with squamous cell carcinoma being the most represented histologic variant. The rising incidence of the neoplastic pathology of this district, coupled with the drastic changes in its epidemiology over the past decades, have posed significant challenges to physicians worldwide in terms of diagnosis, prognosis, and treatment. In order to meet these challenges, a considerable amount of effort has been spent by the authors of the recent literature to explore new technologies and their possible employment for the better diagnostic and prognostic definition of head and neck squamous cell carcinoma (HNSCC). Among these technologies, a growing interest has been gathering around the possible applications of dual-energy computed tomography (DECT) in head and neck pathology. Dual-energy computed tomography (DECT) utilizes two distinct X-ray energy spectra to obtain two datasets in a single scan, allowing for material differentiation based on unique attenuation profiles. DECT offers key benefits such as enhanced contrast resolution, reduced beam-hardening artifacts, and precise iodine quantification through monochromatic reconstructions. It also creates material decomposition images, like iodine maps, aiding in tumor characterization and therapy assessment. This paper aims to summarize recent findings on the use of DECT in HNSCC, providing a comprehensive overview to aid further research and exploration in the field.

Overview of tumor immunotherapy based on approved drugs

Tumor immunotherapy has become a new hotspot for cancer treatment. Various immunotherapies, such as immune checkpoint inhibitors, oncolytic viruses (OVs), cytokines, and cancer vaccines, have been used to treat tumors. They operate through different mechanisms, along with certain toxicities and side effects. Understanding the mechanisms by which immunotherapy modulates the immune system is essential for improving the efficacy and managing these adverse effects. This article discusses various currently approved cancer immunotherapy mechanisms and related agents approved by the Food and Drug Administration, the European Medicines Agency, and the Medicines and Medical Devices Agency. We also review the latest progress in immune drugs approved by the National Medical Products Administration, including monoclonal antibodies, cytokines, OVs, and chimeric antigen receptor-T cell therapy, to help understand the clinical application of tumor immunotherapy.