Abstract Limited immune cell infiltration and deficient presentation of neoepitopes and tumor-associated antigens (TAA) via major histocompatibility complex class I (MHC-I) represent key barriers to effective immunotherapy. This study investigates whether particle radiotherapy (RT) can modulate tumor antigen presentation and T cell recruitment. By evaluating protons, helium, carbon, and oxygen ions, we assessed how distinct biophysical properties—particularly ionization density (linear energy transfer, LET)—influence immune priming. To this end, we evaluated the induction of MHC-I expression in a comprehensive panel of human tumor cell lines (CaSki, SK-MEL-37, A549, PC3, LNCaP), as well as in B16-F1 melanoma, GL261 and 005 genetically engineered glioblastoma models in syngeneic C57BL/6 mouse. Flow cytometry revealed MHC-I upregulation is time-, dose-, and LET-dependent. The role of the cGAS-STING pathway was confirmed using isogenic STING-KO B16 cells, which exhibited reduced RT-induced MHC-I expression. In vivo, high-LET carbon ion irradiation (CIRT) resulted in enhanced tumor MHC-I expression and increased intratumoral infiltration of CD3+ and CD8+ T cells. Adoptive transfer of Superparamagnetic Iron Oxide Nanoparticles (“SPION”)-labeled T cells, followed by high-field MRI tracing, confirmed enhanced intratumoral influx after fractionated (5 × 3 Gy) and single ultra-High Dose Rate (uHDR, FLASH) CIRT. Further characterization of tumor-infiltrating lymphocyte (TIL) composition and immunological memory was performed using single-cell RNA sequencing and mass cytometry (CyTOF). Collectively, these data indicate that modulating RT quality can improve neoantigen expression, MHC-I presentation, and T cell recruitment, highlighting the potential of particle radiotherapy to reprogram the tumor immune microenvironment. Citation Format: Matilde Recusani, Sarah Meister, Federica Ciamarone, Julian Schlegel, Ralph Sinn, Carmen Klein, Jennifer Furkel, Aoife Gahlawat, Christel Herold-Mende, Max Knoll, Michael Breckwoldt, Dirk Jaeger, Juergen Debus, Amir Abdollahi. Enhanced tumor immune cell infiltration and antigen presentation after carbon ion radiotherapy correlates with curative outcomes abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 2837.
Recusani et al. (Fri,) studied this question.