Overcoming the barriers of the tumor: the synergy of photodynamic therapy and immunotherapy

The aim of the study was to study the effectiveness of combination of photodynamic therapy and immunotherapy in cancer treatment.

Material and Methods. We searched and analyzed 843 publications available from WoS, Scopus, MedLine and RSCI databases over the past 5 years. Out of 843 articles, 60 were included in this review.

Results. Preclinical and clinical data indicate the promise of combined photodynamic therapy, which is able to enhance the immune response and overcome resistance to PD-L1 inhibitors by destroying tumor vessels and improving antibody delivery. Photodynamic therapy is actively being investigated as a method of stimulating antitumor immunity, especially in combination with immunotherapy, turning “cold” tumors into “hot” ones. It promotes the growth of cytotoxic T-lymphocytes, suppresses regulatory T-lymphocytes and improves the interaction between tumor and effector cells, while disrupting regulatory mechanisms. Photodynamic therapy can also affect the expression of PD-L1/PD-1. Given the good tolerability of photodynamic therapy, its combination with immunotherapy can increase the effectiveness of treatment while minimizing the risks. Studies have shown that tumor mutation load and PD-L1 expression can predict treatment response in non-small cell lung cancer. In patients with lung adenocarcinoma with low/ moderate tumor mutation load and negative PD-L1, an improvement in overall survival was observed, which is consistent with data on the association of tumor mutation load with response to PD-L1 inhibitors. In the context of gastric cancer, the combination of photodynamic therapy with PD-L1 blockade has shown efficacy in restoring antitumor immunity by increasing the infiltration of cytotoxic T-lymphocytes and reducing the activity of regulatory T-lymphocytes.

Conclusion. The combination of photodynamic therapy and immunotherapy has great potential, as photodynamic therapy destroys cancer cells and stimulates the immune response, and immunotherapy complements and enhances this effect.

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