Thermal ablation in non-small cell lung cancer: A review of treatment modalities and the evidence for combination with immune checkpoint inhibitors

Kanishka Rangamuwa, Tracy Leong, Clare Weeden, Marie Liesse Asselin-Labat, Steven Bozinovski, Michael Christie, Tom John, Phillip Antippa, Louis Irving, Daniel Steinfort

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Lung cancer is the leading cause of cancer death worldwide, with approximately 1.6 million cancer related deaths each year. Prognosis is best in patients with early stage disease, though even then five-year survival is only 55% in some groups. Median survival for advanced non-small cell lung cancer (NSCLC) is 8-12 months with conventional treatment. Immune checkpoint inhibitor (ICI) therapy has revolutionised the treatment of NSCLC with significant long-term improvements in survival demonstrated in some patients with advanced NSCLC. However, only a small proportion of patients respond to ICI, suggesting the need for further techniques to harness the potential of ICI therapy. Thermal ablation utilizes the extremes of temperature to cause tumour destruction. Commonly used modalities are radiofrequency ablation (RFA), cryoablation and microwave ablation (MWA). At present thermal ablation is reserved for curative-intent therapy in patients with localized NSCLC who are unable to undergo surgical resection or stereotactic ablative body radiotherapy (SABR). Limited evidence suggests that thermal ablative modalities can upregulate an anticancer immune response in NSCLC. It is postulated that thermal ablation can increase tumour antigen release, which would initiate and upregulated steps in the cancer immunity cycle required to elicit an anticancer immune response. This article will review the current thermal ablative techniques and their ability to modulate an anti-cancer immune response with a view of using thermal ablation in conjunction with ICI therapy.

Original languageEnglish (US)
Pages (from-to)2842-2857
Number of pages16
JournalTranslational Lung Cancer Research
Volume10
Issue number6
DOIs
StatePublished - Jun 2021
Externally publishedYes

Keywords

  • Cancer immunity
  • Immunotherapy
  • Non-small cell lung cancer (NSCLC)
  • Thermal ablation

ASJC Scopus subject areas

  • Oncology

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