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Therapeutic Ultrasound and Immunotherapy: A Primer

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E Repasky

E Repasky1*, (1) Roswell Park Cancer Institute, Buffalo, NY


7:30 AM : Understanding the Immunological Basis for the Medical Revolution occurring in Cancer Immunotherapy: What are the Implications for Ultrasound, Radiation, and other biophysical therapies? - E Repasky, Presenting Author

TU-A-708-0 (Tuesday, August 1, 2017) 7:30 AM - 8:30 AM Room: 708

After decades of laboratory and clinical research leading to a more complete understanding of how tumors escape immune control, and development of strategies targeting those “checkpoints” that have been blocking immune effector activity, we are now witnessing a medical revolution in oncology where more patients than ever before are experiencing durable remissions with generally tolerable side effects. In just a few years, an unprecedented number of immune-based therapeutic modalities have been FDA approved as first- and second-line therapies across a rapidly growing number of malignancies. This remarkable achievement is resulting in fundamental reassessment of medical care for cancer patients, and has created an urgent need for medical physicists, researchers, clinicians and other health care professionals to learn about tumor immunity, and the latest recommendations for the appropriate application of immunotherapy. This presentation will first provide a basic summary of the immunological principles underlying the use of immunotherapies such as checkpoint inhibitors and CAR-T cells.

It is important to realize that while immunotherapy is changing treatment paradigms for several types of cancer, only 20-44% of patients respond, highlighting the great need to understand why most patients do not respond. Moreover, certain cancers (e.g., pancreatic cancer) appear particularly resistant to immunotherapy. Improving the overall response rate will likely come from strategic combinations with other therapies which can further target immunosuppressive conditions in the tumor microenvironment. Ultrasound and radiation each offer intriguing opportunities for combination with immunotherapy. Therefore, the second goal of this presentation will be to critically assess new pre-clinical and clinical data suggesting that ultrasound-based approaches and radiation therapy can be used to enhance baseline immune responses in tumors, and serve as an adjuvant to immunotherapy.

Learning Objectives:
1. Identify major cellular mechanisms by which tumors are recognized and destroyed by the anti-tumor immune system.
2. Describe major “escape” mechanisms by which tumors can evade or block anti-tumor CD8+ T cells.
3. Become more aware of the progress of literature showing that ultrasound and radiation can be used to enhance anti-tumor immunity.


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