Immune checkpoint inhibitors (ICIs) have revolutionized cancer care, but many patients with poorly immunogenic tumors fail to benefit. Preclinical studies have shown that external beam radiotherapy (EBRT) can synergize with ICI to prompt remarkable tumor regression and even eradication. However, EBRT is poorly suited to widely disseminated disease. Targeted radiopharmaceutical therapy (TRT) selectively delivers radiation to both the primary tumor and the metastatic sites, and promising results achieved with this approach have led to regulatory approval of certain agents (e.g., ¹⁷⁷Lu-PSMA-617/Pluvicto for metastatic prostate cancer). To further improve therapeutic outcomes, combining TRT and ICI is a burgeoning research area, both preclinically and in clinical trials. Here we introduce basic TRT radiobiology and survey emerging and clinically translated TRT agents that have been combined with ICI.

免疫检查点抑制剂 (ICI) 彻底改变了癌症治疗，但许多免疫原性低的肿瘤患者未能从中受益。临床前研究表明，外照射放疗 (EBRT) 可以与 ICI 协同作用，促进显着的肿瘤消退甚至根除。然而，EBRT 不适合广泛传播的疾病。靶向放射药物治疗 (TRT) 选择性地向原发肿瘤和转移部位提供辐射，这种方法取得的有希望的结果已导致某些药物获得监管批准（例如，¹⁷⁷Lu-PSMA-617/Pluvicto 用于转移性前列腺癌）。为了进一步改善治疗效果，结合 TRT 和 ICI 是一个新兴的研究领域，无论是在临床前还是在临床试验中。在这里，我们介绍了基本的 TRT 放射生物学，并调查了与 ICI 结合的新兴和临床转化的 TRT 药物。