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VCS 2020: Targeted Radionuclide Therapy and the Interface between Radiation and Immunotherapy

VCS 2020: Targeted Radionuclide Therapy and the Interface between Radiation and Immunotherapy

VCS 2020: Targeted Radionuclide Therapy and the Interface between Radiation and Immunotherapy

David Vail
David Vail
on behalf of Missouri Veterinary Medical Association

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Launch date: 22 Nov 2020
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Last updated: 27 Jan 2021

Reference: 196389

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Description

Topic: Targeted Radionuclide Therapy and the Interface between Radiation and Immunotherapy
In situ tumor vaccination is a therapeutic strategy that seeks to convert a patient’s own tumor into a nidus for presentation of tumor-specific antigens in a way that will stimulate and diversify an anti-tumor T cell response. Radiation therapy (RT) may serve as a method of in situ tumor vaccination. The mechanisms whereby RT interacts with tumor cells and the TME include: 1) temporary local eradication of RT-sensitive immune lineages including suppressor and effector lymphocytes; 2) local release of inflammatory cytokines and damage-associated molecular patterns resulting in local effects on endothelial cell expression of adhesion receptors, immune cell trafficking, and immune cell activation; 3) immunogenic tumor cell death and release of tumor-specific antigens; and 4) induction of phenotypic changes in the expression of immune susceptibility markers on tumor cells surviving RT. Consequently, RT enhances dendritic cell maturation, antigen cross-presentation, and diversification of anti-tumor T cell response. However, the capacity of external beam RT (EBRT) targeting one tumor to elicit a systemic anti-tumor immune response is limited. This occurs in part, from the local and systemic effects of immunosuppressive cells that pervade the TME in distant non-radiated tumors. Although EBRT may prime a more effective T cell response, when these effector T cells (Teff) circulate to non-radiated tumors they encounter a suppressive TME and poorly susceptible tumor cells. Furthermore, suppressive immune cells [e.g. regulatory T cell (Tregs)] in distant non-radiated metastatic tumors may circulate to the radiated tumor site after RT, and inhibit local priming of tumor reactive T cells. This reflects a need to further address the suppressive TME of distant tumors not targeted by EBRT. While it is not typically feasible to deliver EBRT to all sites of metastatic disease (due to immune suppression and inability to target microscopic disease), we can achieve this using molecular targeted radiotherapy (MTRT).
Exam offered and MVMA CE certificate issued following presentation.

Objectives

. Become fluent in the mechanisms in which radiation therapy can immunomodulate primary tumors and metastatic lesions.
Become fluent in the radiation therapy "abscopal effect" and strategies to enhance this effect
Become fluent in our current limitations regarding how to best deliver radiation therapy to maximize a clinically positive radio-immunologic effect.
David Vail

Author Information Play Video Bio

David Vail
on behalf of Missouri Veterinary Medical Association

David M. Vail, DVM, DACVIM(ONC), Professor and Barbara A. Suran Chair in Comparative Oncology
Dr. David Vail is a professor of oncology and the Barbara A. Suran Chair in Comparative Oncology as well as the Director of the Barbara A. Suran Oncology Research Institute at the University of Wisconsin. Dr. Vail's research involves the design and implementation of comparative oncology clinical trials through the inclusion of companion animal dogs and cats with spontaneous tumors.

Current Accreditations

This course has been certified by or provided by the following Certified Organization/s:

  • Missouri Veterinary Medical Association
  • 0.75 Hours -
    Exam Attempts: 3
    -
    Exam Pass Rate: 60

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