Successful Treatment of Advanced Gastric Cancer with Brain Metastases through an Abscopal Effect by Radiation and Immune Checkpoint Inhibitor Therapy

Muto, Momotaro; Nakata, Hirotaka; Ishigaki, Kenichi; Tachibana, Shion; Yoshida, Moe; Muto, Mizue; Yanagawa, Nobuyuki; Okumura, Toshikatsu

doi:10.5230/jgc.2021.21.e24

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…However, the number of reports of abscopal effect in patients treated with a combination of radiotherapy and ICI has increased (9)(10)(11)(12)(13)(14)(15)(16)(17). In only one year, 2021, 21 case reports of abscopal effect promoted after radiotherapy were yielded (15,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). This is thought to be due to T-cell activation by a damage signal from irradiated dying cells and upregulation of programmed death receptor-1 and programmed cell death 1-ligand 1 (38,39), and an ICI disarms immune escape mechanisms, and this may increase the effects of the innate immune response activated by radiotherapy.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Abscopal effect with fever of unknown cause during radiotherapy: Two case reports and review of the literature

Oshiro,

Mizumoto,

Hisanaga

et al. 2023

Exp Ther Med

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The abscopal effect is a rare phenomenon that is defined as regression of tumor lesions distant from irradiation targets. At our department, two cases with an abscopal effect with fever of unknown cause (FUC) and an inflammatory response during radiotherapy were encountered. Radiotherapy is a local treatment; therefore, it rarely causes systemic side effects during radiotherapy, and if a patient develops a fever during radiotherapy, it is frequently considered tumor fever. We experienced 2 cases of FUC during irradiation followed by abscopal effect. The obvious relationship between the abscopal effect and the fever remains to be clarified. However, FUC during radiotherapy may be a hint to the abscopal effect, considering that immune response and cytokines are closely related to the abscopal effect.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Abscopal effect with fever of unknown cause during radiotherapy: Two case reports and review of the literature

Oshiro,

Mizumoto,

Hisanaga

et al. 2023

Exp Ther Med

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“…Combining radiotherapy (RT) and immune checkpoint inhibitors (ICIs) has definitively turned the abscopal effect (AE) from myth to reality [ 67 ], where there have been 46 cases of AE described in 45 years up to 2014 [ 5 ] and another 58 cases reported in the last 8 years [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , <...…”

Section: Discussionmentioning

confidence: 99%

“…Notably, despite the increasing use of hypo-fractionated or stereotactic ablative RT, known to improve IR’s ability to promote immune responses to tumors [ 4 ], AE has remained a rare phenomenon for a long time, with only 46 cases reported up to 2014 [ 5 ]. However, the introduction of immune checkpoint inhibitors (ICIs), shown to boost the RT-induced immune response [ 6 , 7 ] and to be potentiated by RT [ 8 ], has drastically increased the number of cases reporting AE [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , …”

Section: Introductionmentioning

confidence: 99%

Abscopal Effect on Bone Metastases from Solid Tumors: A Systematic Review and Retrospective Analysis of Challenge within a Challenge

et al. 2023

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Background: Abscopal effect (AE) describes the ability of radiotherapy (RT) to induce immune-mediated responses in nonirradiated distant metastasis. Bone represents the third most frequent site of metastasis and an immunologically favorable environment for the proliferation of cancer cells. We revised the literature, searching documented cases of AE involving bone metastases (BMs) and evaluated the incidence of AE involving BMs in patients requiring palliative RT on BMs or non-BMs treated at our department. Methods: Articles published in the PubMed/MEDLINE database were selected using the following search criteria: ((abscopal effect)) AND ((metastases)). Patients with BMs, who underwent performed bone scintigraphy before and at least 2–3 months after RT, were selected and screened between January 2015 and July 2022. AE was defined as an objective response according to the scan bone index for at least one nonirradiated metastasis at a distance > 10 cm from the irradiated lesion. The primary endpoint was the rate of AE on BMs. Results: Ten cases experiencing AE of BMs were identified from the literature and eight among our patients. Conclusions: The analysis performed here suggests the use of hypofractionated radiotherapy as the only triggering factor for AE of BMs through the activation of the immune response.

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“…However, the number of reports of an abscopal effect in patients treated with a combination of radiotherapy and ICI has increased [7][8][9][10][11][12][13][14][15]. Only in one year of 2021, 21 case reports of abscopal effect promoted after radiotherapy were yielded [13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. This is thought to be due to T-cell activation by a damage signal from irradiated dying cells and upregulation of Programed death receptor-1 (PD-1) and programed cell death 1-Ligand 1 (PDL-1) [36,37], and an ICI disarms immune escape mechanisms, and this may increase the effects of the innate immune response activated by radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Abscopal effect with unknown fever during radiotherapy: Two case reports

Oshiro

Mizumoto

Hisanaga

et al. 2023

Preprint

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The abscopal effect is a rare phenomenon that is defined as regression of tumor lesions distant from irradiation targets. We have experienced two cases with an abscopal effect with unknown fever and an inflammatory response during radiotherapy. Radiotherapy is a local treatment, therefore, it rarely causes systemic side effects during radiotherapy, and if a patient develops a fever during radiotherapy, it is often considered tumor fever. We experienced 2 cases of unknown fever during irradiation followed by abscopal effect. The obvious relationship between the abscopal effect and the unknown fever is not clear. However, Unknown fever during radiotherapy may be a hint to the abscopal effectconsidering that immune response and cytokines closely related to the abscopal effect.

show abstract

Successful Treatment of Advanced Gastric Cancer with Brain Metastases through an Abscopal Effect by Radiation and Immune Checkpoint Inhibitor Therapy

Cited by 6 publications

References 17 publications

Abscopal effect with fever of unknown cause during radiotherapy: Two case reports and review of the literature

Abscopal effect with fever of unknown cause during radiotherapy: Two case reports and review of the literature

Abscopal Effect on Bone Metastases from Solid Tumors: A Systematic Review and Retrospective Analysis of Challenge within a Challenge

Abscopal effect with unknown fever during radiotherapy: Two case reports

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