The Abscopal Effect Exists in Non-small Cell Lung Cancer: A Case Report and Review of the Literature

Bitran, Jacob D.

doi:10.7759/cureus.4118

Cited by 17 publications

(14 citation statements)

References 13 publications

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“…In another recent study, Bitran [25] reported a case of an abscopal response in a metastatic lung cancer patient after local radiation therapy. This case involved a 62-year-old female patient who presented with a stage IV adenocarcinoma of the left lung with a large metastatic left adrenal lesion.…”

Section: Clinical Evidence Of Abscopal Effectsmentioning

confidence: 99%

Systemic Effects of Radiation Therapy-Induced Abscopal Responses in Patients with Advanced Lung Cancer

D’Andrea¹,

Reddy²

2020

Oncology

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Background: Out-of-field tumor regression effects of radiation therapy (abscopal response) have been sporadically observed in the past, but they have only recently gained significant importance due to the use of innovative high-precision radiation delivery devices for the treatment of various cancers including non-small cell lung cancer (NSCLC). In this study, we provide a detailed overview of the current state of knowledge and clinical experience of radiation therapy-induced abscopal effects in patients with advanced NSCLC. Summary: Peer-reviewed published clinical evidence on the abscopal effect of radiation therapy was collected using electronic databases such as MEDLINE via PubMed and Google Scholar. The clinical data on the abscopal effect of radiation therapy were reviewed and the outcomes have been summarized. Most studies describing the abscopal effects of radiation therapy in patients with advanced NSCLC have been in the form of either case reports or small cohort studies. Although the exact molecular mechanisms for the abscopal effect are yet to be established, current evidence indicates that tumor cell destruction induced by local radiation therapy releases tumor antigens, which stimulate the immune system of the host to activate the body’s immune effector cells systemically and trigger the regression of distant nonirradiated cancer cells. These off-target antitumor effects of radiation therapy provide an opportunity to explore the use of the radiation therapy in combination with novel immunotherapy agents to maximize treatment outcomes in patients with advanced NSCLC and other cancers. Key Message: The findings suggest that radiation therapy has the ability to induce abscopal effects with an increased potential to boost these effects when it is used in combination with immunotherapy for the treatment of patients with advanced NSCLC and other cancers. Clinical trials investigating radiation therapy-induced abscopal effects may lead to a dramatic change in its use especially when it is combined with immunotherapy for the treatment of patients with advanced NSCLC.

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Section: Clinical Evidence Of Abscopal Effectsmentioning

confidence: 99%

Systemic Effects of Radiation Therapy-Induced Abscopal Responses in Patients with Advanced Lung Cancer

D’Andrea¹,

Reddy²

2020

Oncology

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“…When one tumour was irradiated in combination with capecitabine, the growth of the contralateral unirradiated tumour was also inhibited. 43 In the clinic, there have been some reports of anti-tumour effects outside the field of irradiation 44 – 46 including in lung cancer, 47 but there is an absence of clinical trial data showing that out-of-field (abscopal) effects contribute to the anti-tumour efficacy of radiation combination therapy.…”

Section: Discussionmentioning

confidence: 99%

Olaparib increases the therapeutic index of hemithoracic irradiation compared with hemithoracic irradiation alone in a mouse lung cancer model

et al. 2021

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Background The radiosensitising effect of the poly(ADP-ribose) polymerase inhibitor olaparib on tumours has been reported. However, its effect on normal tissues in combination with radiation has not been well studied. Herein, we investigated the therapeutic index of olaparib combined with hemithoracic radiation in a urethane-induced mouse lung cancer model. Methods To assess tolerability, A/J mice were treated with olaparib plus whole thorax radiation (13 Gy), body weight changes were monitored and normal tissue effects were assessed by histology. In anti-tumour (intervention) studies, A/J mice were injected with urethane to induce lung tumours, and were then treated with olaparib alone, left thorax radiation alone or the combination of olaparib plus left thorax radiation at 8 weeks (early intervention) or 18 weeks (late intervention) after urethane injection. Anti-tumour efficacy and normal tissue effects were assessed by visual inspection, magnetic resonance imaging and histology. Results Enhanced body weight loss and oesophageal toxicity were observed when olaparib was combined with whole thorax but not hemithorax radiation. In both the early and late intervention studies, olaparib increased the anti-tumour effects of hemithoracic irradiation without increasing lung toxicity. Conclusions The addition of olaparib increased the therapeutic index of hemithoracic radiation in a mouse model of lung cancer.

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“…На сегодняшний день существуют данные о том, что лучевая терапия способствует усилению иммунного ответа, когда ионизирующее излучение сопровождается введением ингибиторов контрольных точек иммунного ответа [34,35] и других иммуномодуляторов, таких как агонистические моноклональные антитела, воздействующие на CD40, гранулоцитарно-макрофагальный колониестимулирующий фактор и интерлейкин-12 [36,37].…”

Section: Discussionunclassified

Abscopal effect in a patient with metastatic NSCLC following a course of radiation therapy to the brain

et al. 2020

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The abscopal effect was described more than 50 years ago and is a phenomenon in which radiation therapy promotes the regression of metastatic foci remote from the site of radiation. For decades, this effect has been described as a rare, unexplained phenomenon in patients receiving radiation therapy. Today, the abscopal effect is still an exceptional phenomenon: the mechanism underlying it is still not fully understood. It is believed that the abscopal effect is most likely associated with systemic immune responses that occur under the influence of radiation therapy.We present the case of a 63-year-old patient with advanced peripheral cancer of the upper lobe of the left lung, disease progression in the form of metastatic brain lesions and regression of tumor foci in the lungs after radiation therapy to the brain, while the patient did not receive additional treatment in the form of immunotherapy.The article examines the history of the abscopal effect, an attempt is made to understand the mechanisms of its occurrence, which can help to further improve the results of treatment of patients with NSCLC using radiation therapy and modern approaches to complex cancer treatment.

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The Abscopal Effect Exists in Non-small Cell Lung Cancer: A Case Report and Review of the Literature

Cited by 17 publications

References 13 publications

Systemic Effects of Radiation Therapy-Induced Abscopal Responses in Patients with Advanced Lung Cancer

Systemic Effects of Radiation Therapy-Induced Abscopal Responses in Patients with Advanced Lung Cancer

Olaparib increases the therapeutic index of hemithoracic irradiation compared with hemithoracic irradiation alone in a mouse lung cancer model

Abscopal effect in a patient with metastatic NSCLC following a course of radiation therapy to the brain

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