1/ Our latest - @JAMAOncology Viewpoint! Ablative radiotherapy has a dual effect on metastatic cancer that changes how we should interpret progression after treatment.
Hot Topics in Lung Cancer Basic and Translational Research is coming up! Submit your abstract by april 15 and come and visit in (hopefully) sunny Dublin!
Speakers include Drew Pardoll, @FSkoulidis@DrJNaidoo@CottrellLab@SeanPitroda among a glittering line up! #lcsm
Contribute to the conversation at #HT26
Explore #immunotherapy resistance alongside leading experts.
📍 Dublin, Ireland | June 26–27
Register & submit your abstract: bit.ly/3NbSROT#LungCancer
💬 Viewpoint: The badscopal effect following ablative radiotherapy signals not failure but biological reorganization, prompting serial metastasis-directed therapy in selected patients. ja.ma/4k0HzJk
Radiotherapy duality in metastatic disease: inhibiting seeding, unmasking dormancy
Viewpoint | jamanetwork.com/journals/jam…@SeanPitroda@rweichselbaum@JAMAOnc@JAMANetwork
Key insights
🟢 Metastasis-directed radiotherapy (MDT) suppresses metastatic seeding from treated lesions
🟢 Ablative RT can unmask dormant distant disease (“badscopal effect”) rather than promote spread
🟢 Post-MDT progression reflects biological reorganization, not treatment failure
🟢 Radiation reshapes systemic immunity (amphiregulin-mediated), enabling dormant clone outgrowth
🟢 Metastatic disease should be viewed as dynamic and iterable, not static
Clinical implications
🟢 Strong rationale for serial MDT, not one-time local therapy
🟢 Explains limited benefit in trials restricting MDT to a single round
🟢 Supports treat-all-visible-disease strategies when feasible
🟢 Calls for MDT personalization using immune phenotype, clonality, and metastatic kinetics
@seanmcbride@drjefstathiou@SeanPitroda@rweichselbaum@JAMAOnc@JAMANetwork@seanmcbride@drjefstathiou#Radiotherapy#OligometastaticDisease#Metastasis#CancerBiology#MDT#Oncology#JAMAOncology
I think Sean's thinking here has been clear from the get go. There's no claim of accelerated progression of non-irradiated mets in the SBRT arm compared to the non-SBRT arm.
The claim is simply that one biological driver of out-of-field progression, when it occurs post-SBRT, acknowledging it occurs LESS FREQUENTLY in the SBRT arms of the trials mentioned, may be amphiregulin driven immune suppression. His work has identified a druggable target that may make the SBRT arms of oligomet trials even more successful than they've already been. Kudos to him! #radonc
In a viewpoint, Sean Pitroda, MD and Ralph Weichselbaum, MD emphasizes the need to personalize treatment based on tumor biology, immune profiles, and metastatic patterns rather than relying on a single treatment. @SeanPitroda@rweichselbaum@LudwigCancerow.ly/BGBL50XvWcf
1/ Our latest - @JAMAOncology Viewpoint! Ablative radiotherapy has a dual effect on metastatic cancer that changes how we should interpret progression after treatment.
Many inducers of inflammation (e.g. RT, chemo, viral) can unmask dormant metastatic cancer cells by shifting the immune landscape. Understanding this common mechanism opens new opportunities to prevent metastatic reactivation.
PMIDs: 40901881, 40614736, 40739350
1/
Our Nature paper on radiation-induced AREG sparked discussion - and some misinterpretation (nature.com/articles/s41586-0…).
We clarify key points in our new Authors’ View in the Red Journal (@IJROBP).
🧵 Here’s what we actually found — and what we didn’t:
sciencedirect.com/science/ar…
1/ New paper 🚨
Radiotherapy (RT) can activate antitumor immunity — but it can also impact metastatic spread in ways we don’t fully understand.
In our new study, we identify a radiation-induced immune checkpoint in dendritic cells (DCs) that limits CD8⁺ T cell priming.
6/
Takeaway:
RT induces YTHDF2 in DCs, which suppresses antigen presentation and limits systemic antitumor immunity.
Targeting YTHDF2 is a promising strategy to enhance RT immune therapy and improve metastatic control.
🔗rupress.org/jem/article/223/…