A Review of the Abscopal Effect in the Era of Immunotherapy

Nabrinsky, Edward; Macklis, Jason; Bitran, Jacob D.

doi:10.7759/cureus.29620

Cited by 25 publications

(18 citation statements)

References 40 publications

(59 reference statements)

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“…Enhancement of immune response to tumor cells by RT has been demonstrated in experimental studies, both in relation to CAR‐T‐cell therapy and in relation to checkpoint inhibitors 27,38,39 . A particular interest has centered on the abscopal effect of RT, that is, the disappearance or reduction of neoplastic lesions located outside the irradiated volume 40–45 . However, despite the reports, this effect is seen rarely and unpredictably, and it has still not been possible to exploit this phenomenon clinically.…”

Section: Primingmentioning

confidence: 99%

“…27,38,39 A particular interest has centered on the abscopal effect of RT, that is, the disappearance or reduction of neoplastic lesions located outside the irradiated volume. [40][41][42][43][44][45] However, despite the reports, this effect is seen rarely and unpredictably, and it has still not been possible to exploit this phenomenon clinically. Part of the reason may be that RT can exert both positive and negative effects on the immune system.…”

mentioning

confidence: 99%

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Reappraisal of the role of radiation therapy in lymphoma treatment

Specht

2023

Hematological Oncology

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Radiation therapy (RT) for lymphomas has improved dramatically with modern imaging and treatment techniques, encompassing only the necessary volume with minimal doses to normal structures. Prescribed radiation doses are reduced, and fractionation schedules are under revision. With effective systemic treatment only initial macroscopic disease is irradiated. With no or less effective systemic treatment, possible microscopic disease is also included. Risks of long‐term side effects of RT have diminished dramatically and should be weighed against risks from more systemic treatment or increased risk of relapse. Lymphoma patients are often elderly, they tolerate modern limited RT very well. Lymphomas refractory to systemic treatments often remain radioresponsive, and brief, mild RT may offer effective palliation. New roles for RT are emerging with immune therapies. RT for “bridging,” keeping the lymphoma under control while waiting for immune therapy, is well established. Enhancement of the immune response to lymphomas, so‐called “priming,” is being intensively researched.

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Section: Primingmentioning

confidence: 99%

mentioning

confidence: 99%

Reappraisal of the role of radiation therapy in lymphoma treatment

Specht

2023

Hematological Oncology

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“…[35][36][37] Although most data for abscopal effect comes from non-small-cell lung cancer (NSCLC), it has been observed in other cancers. 38 Verma et al analyzed the safety of combined immunotherapy and TRT (iRT) in patients from three phase I/II trials and found combined iRT to be safe in the short term (median follow-up was 6.9 months (range, 0.5-30.9 months). 39 The safety of combining ICI and RT was tested in another phase I trial, which enrolled patients with ES-SCLC treated with induction CHT followed by concurrent pembrolizumab and TRT (45 Gy in 15 fractions, with simultaneous integrated boost to the gross tumor allowed to 52.5 Gy).…”

Section: Thoracic Radiotherapy In Es-sclcmentioning

confidence: 99%

The role of thoracic consolidative radiotherapy in the setting of immunotherapy in extensive stage small cell lung cancer

Verma,

Young,

Louie

et al. 2023

Ther Adv Med Oncol

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The improvement in treatment strategies and outcomes in small cell lung cancer (SCLC) has lagged behind other cancers. The addition of immune checkpoint inhibitors (ICIs), durvalumab and atezolizumab, to the platinum-based chemotherapy in frontline setting has improved the survival in extensive stage SCLC, (ES-SCLC), albeit modestly, and is now the new standard of care. Prior to advent of immunotherapy into the therapeutic armamentarium in ES-SCLC, consolidative thoracic radiotherapy (TRT) was associated with improved thoracic control and survival outcomes. In the era of ICIs, the role of TRT is not well defined, chiefly because TRT was not incorporated in any immunotherapy trials, secondly due to concerns regarding the increased risks of pneumonitis, and finally uncertain magnitude of benefit with this combined approach. In principle, radiation can increase in the immunogenicity of tumor and hence the activity of immune checkpoint blockade, thereby increasing efficacy both locally and distantly. Such an approach has been promising in non-small cell lung cancer with ICIs improving outcomes after concurrent chemoradiation, but remains unanswered in ES-SCLC. It is, thus, possible that the modest improvement in survival by addition of ICIs to chemotherapy in ES-SCLC can be further improved by the incorporation of consolidative TRT in selected patients. Several early phase trials and retrospective studies have suggested that such an approach may be feasible and safe. Prospective trials are ongoing to answer whether adding radiation therapy to chemoimmunotherapy will improve outcomes in ES-SCLC.

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“…Critically, these improvements result in significant changes in serum cytokine signalling that is transmitted across the body [14]. This may be mediating the abscopal effect [15]. This effect is established in cancer treatment where specific irradiation of a primary tumour can result in shrinkage of distally located secondary tumours.…”

Section: Introductionmentioning

confidence: 99%

Light stimulation of mitochondria reduces blood glucose levels

Powner,

Jeffery

2024

Journal of Biophotonics

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Mitochondria regulate metabolism, but solar light influences its rate. Photobiomodulation (PBM) with red light (670 nm) increases mitochondrial membrane potentials and adenosine triphosphate production and may increase glucose demand. Here we show, with a glucose tolerance test, that PBM of normal subjects significantly reduces blood sugar levels. A 15 min exposure to 670 nm light reduced the degree of blood glucose elevation following glucose intake by 27.7%, integrated over 2 h after the glucose challenge. Maximum glucose spiking was reduced by 7.5%. Consequently, PBM with 670 nm light can be used to reduce blood glucose spikes following meals. This intervention may reduce damaging fluctuations of blood glucose on the body.

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A Review of the Abscopal Effect in the Era of Immunotherapy

Cited by 25 publications

References 40 publications

Reappraisal of the role of radiation therapy in lymphoma treatment

Reappraisal of the role of radiation therapy in lymphoma treatment

The role of thoracic consolidative radiotherapy in the setting of immunotherapy in extensive stage small cell lung cancer

Light stimulation of mitochondria reduces blood glucose levels

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