Research Spotlight: Systemic Immune Modulation by Stereotactic Radiotherapy in Early-Stage Lung Cancer

Dan G. Duda, DMD, PhD, a researcher and the Director of Translational Research in GI Radiation Oncology at the Edwin L. Steele Laboratories at Massachusetts General Hospital, is the senior author of an article in the journal NPJ Precision Oncology, “Systemic immune modulation by stereotactic radiotherapy in early-stage lung cancer.

What Question Were You Investigating?

We aimed to determine the effect of ablative hypofractionated radiotherapy for lung cancer on effector lymphocyte subsets in patients' blood. Furthermore, we examined the impact of using different doses per fraction of radiotherapy.

What Was Your Approach?

We used samples from patients treated with standard ablative radiotherapy collected before, during, and after treatment.

What Were Your Findings?

This was the first study evaluating the impact of hypofractionated radiotherapy for early lung cancer and the impact of the dose per fraction.

It shows that hypofractionated radiotherapy alone can significantly increase the fraction of proliferating CD4+ and CD8+ circulating T cells in early-stage lung cancer patients.

Most prominently, we detected this effect at the end of treatment and only in the patients who received 10 Gy or less per fraction.

What Are the Implications of Your Findings?

Radiotherapy and immunotherapy are standard therapies for lung cancer. Combining them may lead to synergistic benefits but also to antagonism. Our findings are significant because they might help decision-making for optimally integrating standard immunotherapies with radiotherapy in early-stage lung cancer and potentially other malignancies.

Specifically, they could help schedule the two treatment modalities or allow patient selection for immunotherapy post-radiotherapy.

We are also validating these findings in other cancer types (e.g., liver cancer) and planning a biomarker-driven clinical trial.

Paper Cited:

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In July 2022, Mass General was named #8 in the U.S. News & World Report list of "America’s Best Hospitals." MGH is a founding member of the Mass General Brigham healthcare system.