Improving radiotherapy in cancer treatment: Promises and challenges

Helen H.W Chen, Macus Tien Kuo

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Effective radiotherapy for cancer has relied on the promise of maximally eradicating tumor cells while minimally killing normal cells. Technological advancement has provided state-of-the-art instrumentation that enables delivery of radiotherapy with great precision to tumor lesions with substantial reduced injury to normal tissues. Moreover, better understanding of radiobiology, particularly the mechanisms of radiation sensitivity and resistance in tumor lesions and toxicity in normal tissues, has improved the treatment efficacy of radiotherapy. Previous mechanism-based studies have identified many cellular targets that can affect radiation sensitivity, notably reactive oxygen species, DNA-damaging response signals, and tumor microenvironments. Several radiation sensitizers and protectors have been developed and clinically evaluated; however, many of these results are inconclusive, indicating that improvement remains needed. In this era of personalized medicine in which patients' genetic variations, transcriptome and proteomics, tumor metabolism and microenvironment, and tumor immunity are available. These new developments have provided opportunity for new target discovery. Several radiotherapy sensitivity-associated "gene signatures" have been reported although clinical validations are needed. Recently, several immune modifiers have been shown to associate with improved radiotherapy in preclinical models and in early clinical trials. Combination of radiotherapy and immunocheckpoint blockade has shown promising results especially in targeting metastatic tumors through abscopal response. In this article, we succinctly review recent advancements in the areas of mechanism-driven targets and exploitation of new targets from current radio-oncogenomic and radiation-immunotherapeutic approaches that bear clinical implications for improving the treatment efficacy of radiotherapy.

Original languageEnglish
Pages (from-to)62742-62758
Number of pages17
JournalOncotarget
Volume8
Issue number37
DOIs
Publication statusPublished - 2017 Sep 1

Fingerprint

Radiotherapy
Neoplasms
Tumor Microenvironment
Radiation Tolerance
Therapeutics
Radiation-Sensitizing Agents
Radiobiology
Precision Medicine
Radio
Transcriptome
Proteomics
Immunity
Reactive Oxygen Species
Clinical Trials
Radiation
DNA
Wounds and Injuries
Genes

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Chen, Helen H.W ; Kuo, Macus Tien. / Improving radiotherapy in cancer treatment : Promises and challenges. In: Oncotarget. 2017 ; Vol. 8, No. 37. pp. 62742-62758.
@article{41aeabcfbdec4e35885e07b0a3b193be,
title = "Improving radiotherapy in cancer treatment: Promises and challenges",
abstract = "Effective radiotherapy for cancer has relied on the promise of maximally eradicating tumor cells while minimally killing normal cells. Technological advancement has provided state-of-the-art instrumentation that enables delivery of radiotherapy with great precision to tumor lesions with substantial reduced injury to normal tissues. Moreover, better understanding of radiobiology, particularly the mechanisms of radiation sensitivity and resistance in tumor lesions and toxicity in normal tissues, has improved the treatment efficacy of radiotherapy. Previous mechanism-based studies have identified many cellular targets that can affect radiation sensitivity, notably reactive oxygen species, DNA-damaging response signals, and tumor microenvironments. Several radiation sensitizers and protectors have been developed and clinically evaluated; however, many of these results are inconclusive, indicating that improvement remains needed. In this era of personalized medicine in which patients' genetic variations, transcriptome and proteomics, tumor metabolism and microenvironment, and tumor immunity are available. These new developments have provided opportunity for new target discovery. Several radiotherapy sensitivity-associated {"}gene signatures{"} have been reported although clinical validations are needed. Recently, several immune modifiers have been shown to associate with improved radiotherapy in preclinical models and in early clinical trials. Combination of radiotherapy and immunocheckpoint blockade has shown promising results especially in targeting metastatic tumors through abscopal response. In this article, we succinctly review recent advancements in the areas of mechanism-driven targets and exploitation of new targets from current radio-oncogenomic and radiation-immunotherapeutic approaches that bear clinical implications for improving the treatment efficacy of radiotherapy.",
author = "Chen, {Helen H.W} and Kuo, {Macus Tien}",
year = "2017",
month = "9",
day = "1",
doi = "10.18632/oncotarget.18409",
language = "English",
volume = "8",
pages = "62742--62758",
journal = "Oncotarget",
issn = "1949-2553",
publisher = "Impact Journals",
number = "37",

}

Improving radiotherapy in cancer treatment : Promises and challenges. / Chen, Helen H.W; Kuo, Macus Tien.

In: Oncotarget, Vol. 8, No. 37, 01.09.2017, p. 62742-62758.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Improving radiotherapy in cancer treatment

T2 - Promises and challenges

AU - Chen, Helen H.W

AU - Kuo, Macus Tien

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Effective radiotherapy for cancer has relied on the promise of maximally eradicating tumor cells while minimally killing normal cells. Technological advancement has provided state-of-the-art instrumentation that enables delivery of radiotherapy with great precision to tumor lesions with substantial reduced injury to normal tissues. Moreover, better understanding of radiobiology, particularly the mechanisms of radiation sensitivity and resistance in tumor lesions and toxicity in normal tissues, has improved the treatment efficacy of radiotherapy. Previous mechanism-based studies have identified many cellular targets that can affect radiation sensitivity, notably reactive oxygen species, DNA-damaging response signals, and tumor microenvironments. Several radiation sensitizers and protectors have been developed and clinically evaluated; however, many of these results are inconclusive, indicating that improvement remains needed. In this era of personalized medicine in which patients' genetic variations, transcriptome and proteomics, tumor metabolism and microenvironment, and tumor immunity are available. These new developments have provided opportunity for new target discovery. Several radiotherapy sensitivity-associated "gene signatures" have been reported although clinical validations are needed. Recently, several immune modifiers have been shown to associate with improved radiotherapy in preclinical models and in early clinical trials. Combination of radiotherapy and immunocheckpoint blockade has shown promising results especially in targeting metastatic tumors through abscopal response. In this article, we succinctly review recent advancements in the areas of mechanism-driven targets and exploitation of new targets from current radio-oncogenomic and radiation-immunotherapeutic approaches that bear clinical implications for improving the treatment efficacy of radiotherapy.

AB - Effective radiotherapy for cancer has relied on the promise of maximally eradicating tumor cells while minimally killing normal cells. Technological advancement has provided state-of-the-art instrumentation that enables delivery of radiotherapy with great precision to tumor lesions with substantial reduced injury to normal tissues. Moreover, better understanding of radiobiology, particularly the mechanisms of radiation sensitivity and resistance in tumor lesions and toxicity in normal tissues, has improved the treatment efficacy of radiotherapy. Previous mechanism-based studies have identified many cellular targets that can affect radiation sensitivity, notably reactive oxygen species, DNA-damaging response signals, and tumor microenvironments. Several radiation sensitizers and protectors have been developed and clinically evaluated; however, many of these results are inconclusive, indicating that improvement remains needed. In this era of personalized medicine in which patients' genetic variations, transcriptome and proteomics, tumor metabolism and microenvironment, and tumor immunity are available. These new developments have provided opportunity for new target discovery. Several radiotherapy sensitivity-associated "gene signatures" have been reported although clinical validations are needed. Recently, several immune modifiers have been shown to associate with improved radiotherapy in preclinical models and in early clinical trials. Combination of radiotherapy and immunocheckpoint blockade has shown promising results especially in targeting metastatic tumors through abscopal response. In this article, we succinctly review recent advancements in the areas of mechanism-driven targets and exploitation of new targets from current radio-oncogenomic and radiation-immunotherapeutic approaches that bear clinical implications for improving the treatment efficacy of radiotherapy.

UR - http://www.scopus.com/inward/record.url?scp=85028744851&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028744851&partnerID=8YFLogxK

U2 - 10.18632/oncotarget.18409

DO - 10.18632/oncotarget.18409

M3 - Review article

AN - SCOPUS:85028744851

VL - 8

SP - 62742

EP - 62758

JO - Oncotarget

JF - Oncotarget

SN - 1949-2553

IS - 37

ER -