pairingsPairing
Radiotherapy + immunotherapy
Radiation turns the irradiated tumour into a vaccine; immunotherapy spreads the response.
PACIFIC (durvalumab after chemoradiation, OS benefit), KEYNOTE-A18 (cervical), NRG/RTOG trials. Abscopal responses with SBRT + IO are real but inconsistent; PEMBRO-RT positive, others negative. Timing, dose, and site matter.
Rationale
Radiation induces immunogenic cell death, cGAS-STING signalling, MHC upregulation, and antigen release; PD-L1 rises after radiation, which checkpoint blockade counters.
Evidence
Phase 3 positive in consolidation settings; abscopal effect less consistent.