Ra-SBRT is Potential Immune Adjuvant for Innate Immune Cell Populations in Advance Stage NSCLC Patients

Abstract

Bystander toxicity and tissue fibrosis are the major complications with conventional radiation therapy for cancer patients. In this context, we here propose RapidArc -Stereotactic Body Radiation Therapy (Ra-SBRT) as a noninvasive and immune adjuvant approach for the successful eradication of advance stage NSCLC. Ra-SBRT is highly focused and capable of destroying tumors with high grade metastatic lesions and spared normal tissues. Follow up of stage 4th NSCLC patient revealed that Ra-SBRT is potentially immunogenic which was evident by increased number of iNOS+ Tumor Associated macrophages (M1-TAM), Siglac-8+ eosinophils, basophils and subsequent prolongation of disease free survival of 4th stage NSCLC patients by 3 years. This study demonstrated M1 retuning potential of Ra-SBRT which is a pre-requisite of effective management of inoperable and highly metastatic tumors of lung with least or no bystander impact.