ArticleNature communications2022
Elective nodal irradiation mitigates local and systemic immunity generated by combination radiation and immunotherapy in head and neck tumors.
Article in Nature communications, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07146230 (The Selective Personalized Radio-Immunotherapy for Locally Advanced NSCLC Trial 2), which is not on this map. Cited by 140 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Selective Personalized Radio-Immunotherapy for Locally Advanced NSCLC Trial 2 (SPRINT 2)
Who cites it
140 citing papers in PubMed, 3 syntheses or guidelines pooled it, 193 citations in OpenAlex.
- The Addition of Concurrent Immune Checkpoint Inhibitors for Chemoradiotherapy With Consolidative Immune Checkpoint Inhibitors in Unresectable Cancers: A Systematic Review and Meta-Analysis.International journal of cancer · 2026Pooled it
- Efficacy and safety of sequential versus concurrent administration of immune checkpoint inhibitors with radiotherapy in solid tumors: a systematic review and network meta-analysis.Cancer immunology, immunotherapy : CII · 2026Pooled it
- Immune modulatory roles of radioimmunotherapy: biological principles and clinical prospects.Frontiers in immunology · 2024Pooled it
- Neoadjuvant stereotactic body radiation therapy with durvalumab and oleclumab in ERNature medicine · 2026Trial
- Rescue by radiotherapy and anti-CTLA4/PD-1 after failure of anti-PD-1 therapy in patients with metastatic NSCLC: the phase II RECLAIM trial.Journal for immunotherapy of cancer · 2026Trial
- Atezolizumab and Stereotactic Body Radiation in Metastatic, Recurrent, or Persistent Cervical Cancer: Results From a Phase 2 Multi-Institutional Study.International journal of radiation oncology, biology, physics · 2026Trial
- Neoadjuvant immunochemoradiotherapy with nivolumab, paclitaxel, and cisplatin followed by esophagectomy for locally advanced esophageal squamous cell carcinoma.British journal of cancer · 2026Trial
- Tumor ecosystem and microbiome features associated with efficacy and resistance to avelumab plus chemoradiotherapy in head and neck cancer.Nature cancer · 2026Trial
- Neoadjuvant or concurrent atezolizumab with chemoradiation for locally advanced cervical cancer: a randomized phase I trial.Nature communications · 2025Trial
- Safety and efficacy of pembrolizumab, radiation therapy, and surgery versus radiation therapy and surgery for stage III soft tissue sarcoma of the extremity (SU2C-SARC032): an open-label, randomised clinical trial.Lancet (London, England) · 2024Trial
- Trial
- Unlocking the therapeutic potential of immuno-radiotherapy: insights from preclinical and clinical research.Oncoimmunology · 2026Review
- A systematic review of heterogeneity in clinical trial design for anal cancer radiotherapy-immunotherapy combinations.Clinical and translational radiation oncology · 2026Review
- Tumor-Regional Immune Microenvironment: A Critical Factor in the Design of Radiotherapy-Immunotherapy Combination Trials.International journal of cancer · 2026Review
- Mechanisms of systemic immune modulation in tumor development: Interactions across lymph nodes, bone marrow, and blood.Cancer metastasis reviews · 2026Review
- Ectopic integrin β1 overproduction by squamous carcinoma cells contributes to immune evasion-associated metastasis.Cancer letters · 2026Article
- Immune-pressure redistribution in resistance to PD-1/PD-L1 blockade: mechanisms, biomarkers, and therapeutic design.Molecular cancer · 2026Review
- Challenges and opportunities in combining radiotherapy and immunotherapy for localized pancreatic cancer.Nature reviews. Gastroenterology & hepatology · 2026Review
- Pathological lymph node response after immunotherapy-based total neoadjuvant therapy supports local excision for organ preservation in locally advanced rectal cancer: a propensity-score weighted analysis.Clinical and translational radiation oncology · 2026Article
- Combining Radiation Therapy and Tumor-Infiltrating Lymphocyte Therapy: Biological Rationale, Clinical Synergies, and Future Directions.Current oncology (Toronto, Ont.) · 2026Review
80 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
20 authors at 5 institutions in 2 countries.
Funding
Abstract
In the setting of conventional radiation therapy, even when combined with immunotherapy, head and neck cancer often recurs locally and regionally. Elective nodal irradiation (ENI) is commonly employed to decrease regional recurrence. Given our developing understanding that immune cells are radio-sensitive, and that T cell priming occurs in the draining lymph nodes (DLNs), we hypothesize that radiation therapy directed at the primary tumor only will increase the effectiveness of immunotherapies. We find that ENI increases local, distant, and metastatic tumor growth. Multi-compartmental analysis of the primary/distant tumor, the DLNs, and the blood shows that ENI decreases the immune response systemically. Additionally, we find that ENI decreases antigen-specific T cells and epitope spreading. Treating the primary tumor with radiation and immunotherapy, however, fails to reduce regional recurrence, but this is reversed by either concurrent sentinel lymph node resection or irradiation. Our data support using lymphatic sparing radiation therapy for head and neck cancer.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.