Abscopal effect of radiation on lymph node metastasis in esophageal carcinoma: A case report and literature review

Zhao, Xiangfei; Kang, Jae-Heon; Zhao, Rugang

doi:10.3892/ol.2018.9084

Cited by 17 publications

(22 citation statements)

References 19 publications

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“…The abscopal effect was mostly expected during the treatment of these tumors. In our review, remarkable abscopal responses were also seen in other histologic types, such as gastric, esophageal, or pancreatic cancers [17,[21][22]. This observation is consistent with preclinical data, suggesting that the combination of RT and immunotherapy induces effective immune responses to poorly immunogenic carcinomas [28][29].…”

Section: Patient Selectionsupporting

confidence: 85%

Abscopal Effect of Radiotherapy in the Immunotherapy Era: Systematic Review of Reported Cases

Dağoğlu¹,

Karaman²,

Çağlar³

et al. 2019

Cureus

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Mounting evidence suggests that radiation stimulates the immune system and this contributes to the abscopal effect, which is defined as “response at a distance from the irradiated volume.” Though identified more than 50 years ago, the abscopal effect is revisited today. One rationale is that the abscopal effect is often observed with efficient immunotherapy. Here, we give an overview of the clinical data on the abscopal effect, generated by a combination of immunotherapy and radiotherapy (RT). Only papers that included RT in combination with immunotherapy were evaluated according to four main categories including RT parameters, sequencing of therapies, the definition of the abscopal effect, and patient selection. Twenty-four cases in 15 reports were reviewed. The results varied. Patient ages ranged from 24 to 74. RT dose (median total dose 18-58 Gy) varied. Biologically effective dose (BED) 10 was calculated to be a median 49.65 Gy (28-151 Gy). The time to a documented abscopal response ranged from less than a month to 12 months. The large variation concerning fractionation and sequencing of therapies indicates that these conflicting points need to be resolved, to generate for the abscopal effect to be clinically significant.

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Section: Patient Selectionsupporting

confidence: 85%

Abscopal Effect of Radiotherapy in the Immunotherapy Era: Systematic Review of Reported Cases

Dağoğlu¹,

Karaman²,

Çağlar³

et al. 2019

Cureus

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“…Recent studies have demonstrated that an abscopal effect can be induced in patients by the combination of radiotherapy and anti-PD1-therapy (nivolumab 63,64 , pembrolizumab 65,66 ), anti-CTLA-4 therapy (Ipilimumab 67 ) and granulocyte-macrophage colony-stimulating factor (GM-CSF) therapy 68 . We previously found 29 that combining Prop with anti-PD-1 in murine tumor models results in a significant improvement in anti-PD-1 efficacy.…”

Section: Discussionmentioning

confidence: 99%

Adrenergic stress constrains the development of anti-tumor immunity and abscopal responses following local radiation

et al. 2020

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The abscopal effect following ionizing radiation therapy (RT) is considered to be a rare event. This effect does occur more frequently when combined with other therapies, including immunotherapy. Here we demonstrate that the frequency of abscopal events following RT alone is highly dependent upon the degree of adrenergic stress in the tumor-bearing host. Using a combination of physiologic, pharmacologic and genetic strategies, we observe improvements in the control of both irradiated and non-irradiated distant tumors, including metastatic tumors, when adrenergic stress or signaling through β-adrenergic receptor is reduced. Further, we observe cellular and molecular evidence of improved, antigen-specific, anti-tumor immune responses which also depend upon T cell egress from draining lymph nodes. These data suggest that blockade of β2 adrenergic stress signaling could be a useful, safe, and feasible strategy to improve efficacy in cancer patients undergoing radiation therapy.

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“…Nevertheless, some studies suggest that the abscopal effect is relatively rare due to the immunotolerance of the tumor, which results in a reduced systemic immune response. However, treatment with immune checkpoint inhibitors might overcome this immunosuppression, thus converting an immunologically “cold” tumor into a “hot” tumor (171, 172).…”

Section: A Brief Comment On the Abscopal Effect And Its Consequences mentioning

confidence: 99%

Liquid Biopsy in Oligometastatic Prostate Cancer—A Biologist's Point of View

et al. 2019

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Prostate cancer (PCa) is the main cause of cancer-related mortality in males and the diagnosis, treatment, and care of these patients places a great burden on healthcare systems globally. Clinically, PCa is highly heterogeneous, ranging from indolent tumors to highly aggressive disease. In many cases treatment—generally either radiotherapy (RT) or surgery—can be curative. Several key genetic and demographic factors such as age, family history, genetic susceptibility, and race are associated with a high incidence of PCa. While our understanding of PCa, which is mainly based on the tools of molecular biology—has improved dramatically in recent years, efforts to better understand this complex disease have led to the identification of a new type of PCa–oligometastatic PCa. Oligometastatic disease should be considered an individual, heterogeneous entity with distinct metastatic phenotypes and, consequently, wide prognostic variability. In general, patients with oligometastatic disease typically present less biologically aggressive tumors whose metastatic potential is more limited and which are slow-growing. These patients are good candidates for more aggressive treatment approaches. The main aim of the presented review was to evaluate the utility of liquid biopsy for diagnostic purposes in PCa and for use in monitoring disease progression and treatment response, particularly in patients with oligometastatic PCa. Liquid biopsies offer a rapid, non-invasive approach whose use t is expected to play an important role in routine clinical practice to benefit patients. However, more research is needed to resolve the many existing discrepancies with regard to the definition and isolation method for specific biomarkers, as well as the need to determine the most appropriate markers. Consequently, the current priority in this field is to standardize liquid biopsy-based techniques. This review will help to improve understanding of the biology of PCa, particularly the recently defined condition known as “oligometastatic PCa”. The presented review of the body of evidence suggests that additional research in molecular biology may help to establish novel treatments for oligometastatic PCa. In the near future, the treatment of PCa will require an interdisciplinary approach involving active cooperation among clinicians, physicians, and biologists.

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Abscopal effect of radiation on lymph node metastasis in esophageal carcinoma: A case report and literature review

Cited by 17 publications

References 19 publications

Abscopal Effect of Radiotherapy in the Immunotherapy Era: Systematic Review of Reported Cases

Abscopal Effect of Radiotherapy in the Immunotherapy Era: Systematic Review of Reported Cases

Adrenergic stress constrains the development of anti-tumor immunity and abscopal responses following local radiation

Liquid Biopsy in Oligometastatic Prostate Cancer—A Biologist's Point of View

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