Cure Alveolar Soft Part Sarcoma International (iCureASPS)

OBJECTIVE. We provide a brief review of the tumor microenvironment, the impact of six interventional radiology treatments on the tumor microenvironment, and potential methods to improve treatment efficacy.

CONCLUSION. Interventional oncology plays a unique role in cancer therapy, contributing to both antitumorigenic and protumorigenic effects.

Keywords: ablation, electroporation, embolization, interventional oncology, microenvironment, tumor




https://www.ajronline.org/doi/full/10.2214/AJR.16.17677

It is a very interesting article that shows the problems that can arise when the local treatments to selected metastasis are used with the goal of combining them with the immune-checkpoint inhibitors to create the abscopal effect via attracting the immune cell toward the treated mets and creating the tumor-specific memory T-cells. That will go elsewhere and consume the tumor cells everywhere.
The problem is that all of these modalities can be both - immune-stimulating or immune-suppressing or stimulating the wrong types of immune cells, the ones that are used by the tumors to evade the destruction.
It may explain different results we saw in different ASPS patients tried to enhance the effect of the ICI drugs. Radiosurgery seems more predictable but might have an immune suppressing effect as well when the volume of the necrotic tissue of the treated tumor is to large and the inflammation after the treatment is to much of the burden for immune system to deal with. More questions than answers.