In situ vaccine effect of radiotherapy is associated with intratumoural ERV reactivation and RNA virus sensing

Radiotherapy (RT) transforms tumour tissues into in situ vaccines that trigger antitumor immunity. Immunogenicity depends on how RT is delivered, since heterogeneous RT (spatially fractionated RT, SFRT) elicits more prominent responses than the conventional homogenous one. However, this phenomenon cannot be clinically harnessed, unless the relevant pathways are identified. To gain insights, we developed a hybrid dry-lab/wet-lab approach that integrates systems-level immune phenotypes established by homogenous or heterogenous RT (SFRT) with the transcriptomic profiling of irradiated tumors. By further combining feature extraction with machine-learning, including multilayer perceptron modelling, we ranked predictors of immune infiltration and patient survivability for each RT type. We found that conventional RT induces coordinated upregulation of cytosolic sensors of RNA viruses (OASes and RIG I-like receptors) along with ERV RNAs predominately 400-800 base-pairs long, which might serve as their ligands. For schemes establishing abscopal effects, a coordinated upregulation of the OAS sensors and shared ERV transcripts was observed in both irradiated and distant tumours. Compared to homogenous RT, SFRT triggered earlier and stronger activation of OAS signaling along with NK cell responses. Overall, we show a co-involvement of tumour cell-intrinsic ERVs and their cytosolic RNA sensors in RT-induced antitumor immunity. This key finding could guide mechanistic studies and future precision oncology.