The Confluence of Stereotactic Ablative Radiotherapy and Tumor Immunology

Figure 1

Confluence of SABR and Immunotherapy. Apoptosis can be initiated by SABR-induced DNA damage and upregulation of the p53 tumor suppressor gene. In addition, apoptosis can be triggered by SABR-induced damage to the cellular lipid membrane, which can induce ceramide formation and activate the SAPK/JNK signaling pathway. Thus, SAPK/JNK can upregulate PKR expression, which can induce MHC and cytokines via NF-κB. SABR can induce cellular expression of MHC Class I, adhesion molecules, costimulatory molecules, heat shock proteins, inflammatory mediators, immunomodulatory cytokines, and death receptors.