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. 2018 Aug 13;24(1):e49–e52. doi: 10.1634/theoncologist.2018-0205

Figure 3.

image

Schematic representation of the in‐situ vaccine phenomenon created by radiation at all levels of immune response. Blue arrows represent direct and indirect effects of radiation (+, antitumor effects; −, protumor effects), whereas yellow arrows represent the suppressive effect of TREGs antagonized by ipilimumab. Note that anti‐PD‐1 (nivolumab) antagonizes the upregulated PD‐L1 and helps reverse the resistance and promote tumor rejection.Abbreviations: ADCC, antibody‐dependent cellular cytotoxicity; anti‐PD‐1, anti‐programmed death‐1 antibody; ATP, adenosine triphosphate; CTLA‐4, cytotoxic T‐lymphocyte antigen‐4; DAMP, damage‐associated molecular pattern; DC, dendritic cell; HMGB1, high‐mobility group protein B1; IFN‐1; interferon‐1; MHC‐1, major histocompatibility complex‐1; NK, natural killer; NKG2D, natural killer group 2, member D; PD‐L1, programmed death ligand‐1; TREG, T regulatory lymphocyte; XRT, radiation.