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    Radiation dose and fraction in immunotherapy: one-size regimen does not fit all settings, so how does one choose? by Marka Crittenden, Sandra Demaria, C Norman Coleman, Jonathan Schoenfeld, Arta Monjazeb, Samir Khleif, Seema Gupta, Andrew Sikora, Zachary Morris, Chandan Guha, Stephen Shiao, Silvia Chiara Formenti, Bhadrasain Vikram, Mansoor M Ahmed

    Published 2021-04-01
    “…Radiation oncologists and immunologists convened a virtual consensus discussion to identify current deficiencies, challenges, pitfalls and critical gaps when combining radiotherapy with immunotherapy and making recommendations to the field and advise National Cancer Institute on new directions and initiatives that will help further development of these two fields.This commentary aims to raise the awareness of this complexity so that the need to study radiation dose, fractionation, type and volume is understood and valued by the immuno-oncology research community. Divergence of approaches and findings between preclinical studies and clinical trials highlights the need for evaluating the design of future clinical studies with particular emphasis on radiation dose and fractionation, immune biomarkers and selecting appropriate end points for combination radiation/immune modulator trials, recognizing that direct effect on the tumor and potential abscopal effect may well be different. …”
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