By. Arta Monjazeb, MD
Date: 11/21/2023
Arta Monir Monjazeb, MD, explores cancer immunotherapy with a detailed discussion on the immune response, radiation’s role, and the challenges of combining radiotherapy with immune checkpoint inhibitors (ICI). As a prominent figure in the field, Dr. Monjazeb brings forth insights that bridge clinical practice and research.
In an exploration of the immune response, Dr. Monjazeb emphasizes the role of antigen-presenting cells in transitioning from innate to adaptive immunity. He discusses the intricate relationship between radiation and the immune system, emphasizing the importance of immunogenic cell death and the subsequent activation of T cells.
Touching upon disparities among cancer types, Dr. Monjazeb articulates the varying effects of radiation and the need for tailored approaches. His discourse extends to the combination of radiation and immune checkpoint inhibitors, showcasing successes observed in non-small cell lung cancer. With a measured perspective, he questions whether these triumphs are inherent to the cancer type or a consequence of focused research.
The conversation takes a pragmatic turn as Dr. Monjazeb acknowledges the hurdles in combining radiotherapy with ICI, citing trial outcomes. He dissects the challenges, questioning the appropriateness of radiation doses, fractionation, and timing. Dr. Monjazeb highlights the critical need for a deeper understanding of the optimal conditions for combining these therapeutic modalities.
In response to the interviewer’s probing on strategies for improvement, Dr. Monjazeb delineates a two-fold approach. First, he scrutinizes the methodology of testing radiation, emphasizing the necessity of refining the dose, fractionation, and timing. Second, he postulates that radiation alone may not suffice for cancers resistant to immune checkpoint inhibitors, advocating for a combination with immunostimulatory agents to enhance the immune response.
The interview culminates in a discussion of a canine trial involving radiation, the TLR9 agonist SD 101, and the IDO inhibitor epacadostat. Dr. Monjazeb elucidates the rationale behind the selection of these agents, drawing from previous studies at Stanford. The trial aims to address limitations observed in earlier efforts by blocking IDO, potentially amplifying the treatment’s effectiveness.
In this conversation, Dr. Arta Monjazeb, MD, emerges as a thought leader navigating the complexities of cancer immunotherapy, offering valuable perspectives on the immune response, challenges faced, and innovative strategies to enhance therapeutic outcomes.