10123 - Radiation as an immunological adjuvant: current evidence on dose and fractionation

Course Directors

Sandra Demaria, M.D., NYU Langone Medical Center and School of Medicine
Silvia C. Formenti, M.D., NYU Langone Medical Center and School of Medicine


Ionizing radiation to a cancer site has the ability to convert the irradiated tumor in an immunogenic hub. However, radiation is a complex modifier of the tumor microenvironment and, by itself, is seldom sufficient to induce a therapeutically significant anti-tumor immune response, since it can also activate immune suppressive pathways. While several combinations of local radiation and immunotherapy have been shown in pre-clinical models to induce powerful anti-tumor immunity, the optimal strategy to achieve this effect remains to be defined. This course critically reviews the available in vitro and in vivo data on this subject and discusses the potential impact of fractionation on the ability of radiation to synergize with immunotherapy.


AMA PRA Category 1 Credits™

Opus Medicus designates this Internet enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Maintenance of Certification (MOC) Credits

In addition to AMA PRA Category 1 Credits™, Opus Medicus designates this course for Specialty Board MOC Program Credits:

1.25 ABIM MOC Points1

Accreditation Statement

Opus Medicus is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Tuition Fees

Course: Free
Credits: $30.00

Course Dates

Last Review Date: 08-Apr-2018
Expiration Date: 07-Apr-2021


After completing this course, participants will understand:

1. Radiation-induced cell death and the implications for immunotherapy combinations.

2. Effects on tumor cells of single dose versus fractionated radiation.


1. Introduction

2. Radiation-Induced Cell Death, Implications For Immunotherapy Combinations

3. Experiments testing single fractions of radiation

4. Experiments testing dose fractionation

5. Learning from clinical experience

6. Challenges and future directions

7. Conclusions

American Board of Medical Specialties (ABMS) / Accreditation Council for Graduate Medical Education (ACGME) Competencies

☑  Patient Care (PC)
☑  Medical Knowledge (MK)
☑  Systems-Based Practice (SBP)

Financial Relationship Disclosure and Content Attestation

Drs. Sandra Demaria and Silvia C. Formenti attest that they have no financial relationships with a commercial entity offering healthcare related products and/or services. Dr. Steven R. Tahan, Education Committee Chair, attests that commercial entities with which he has relationships do not offer healthcare related products or services relevant to the content of this course. No other person who has provided content for or who can influence the content of this course has disclosed financial relationships with commercial entities that offer healthcare-related products or services relevant to the course content.

There has been no commercial support for this course.

Supported Computer Hardware and Software Configurations2

Supported client computing platforms include:

A broadband Internet connection is required (e.g., cable, DSL, and 3G or 4G wireless). The course presentation is automatically scaled to the size of the display, from 800x480 pixels (minimum supported) to 1920x1200 pixels. On some smart phones, viewing courses may be tedious.

Supported browsers include:

Javascript, cookies, and popups must be enabled on your browser (which is the default configuration for most browsers).

1. Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.25 MOC points in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) Program, in addition to AMA PRA Category 1 Credits™. Participants will earn MOC points equivalent to the amount of AMA PRA Category 1 credits claimed for the activity. Immediately upon course completion, Opus Medicus will submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

2. The course may also be viewable on other client computing platforms that comply with Internet standards. If you experience technical problems that prevent you from viewing the course, we will promptly issue a full refund upon request.