Dr. Schoenfeld on Low-Dose Radiation Plus Immunotherapy in Head and Neck Cancer

Jonathan D. Schoenfeld, MD, MPhil, MPH, director, melanoma radiation oncology, physician, assistant professor of radiation oncology, Harvard Medical School, Dana-Farber Cancer Institute, discusses potential combination regimens of low-dose radiation therapy and immunotherapy to treat patients with head and neck cancer.

As these strategies become more targeted, explains Schoenfeld, and as stereotactic body radiation therapy continues to be explored in multiple tumor types and in multiple locations in the body, there are an increasing number of potential combinations that could be evaluated with immuno-oncology agents.

Currently, radiation therapy in the locally advanced setting is given in small daily doses over 4 to 7 weeks. There is some concern, especially when the radiation is administered to a large portion of the body, that it can act as an immune suppresser. This may not be the best way to combine radiation with immunotherapy.

Some data have explored the use of lower doses of radiation, and some preclinical research has suggested that the lower doses may have immunologic effects, both positive and negative, he explains. These combinations will be tested in upcoming trials and may prove beneficial in some cases.