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      Abscopal Effect after Stereotactic Body Radiotherapy with Nivolumab for Lung Metastasis of Head and Neck Cancer: A Case Report

      case-report

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          Abstract

          Introduction

          The abscopal effect (AE) is a phenomenon, in which radiotherapy exerts an antitumour effect on distant lesions outside the primary irradiated area. Although immune checkpoint inhibitors have been widely studied for their potential to enhance the AE and improve patient outcomes, findings in cases of head and neck cancers remain limited.

          Case Presentation

          We report the case of a 72-year-old man who experienced lung oligoprogression during nivolumab treatment for metastatic hypopharyngeal cancer. Stereotactic body radiotherapy (SBRT) was administered to one of the lung lesions, after which both irradiated and nonirradiated lesions regressed. Upon an 18-month follow-up period after SBRT, the patient showed no disease progression or toxicity, and continued receiving nivolumab therapy.

          Conclusion

          The intent behind presenting this case report was to contribute to the accumulation of evidence regarding the AE in cases of head and neck cancer.

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          Most cited references19

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          Effect of Pembrolizumab After Stereotactic Body Radiotherapy vs Pembrolizumab Alone on Tumor Response in Patients With Advanced Non–Small Cell Lung Cancer

          Many patients with advanced non-small cell lung cancer (NSCLC) receiving immunotherapy show primary resistance. High-dose radiotherapy can lead to increased tumor antigen release, improved antigen presentation, and T-cell infiltration. This radiotherapy may enhance the effects of checkpoint inhibition.
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            Immunologic correlates of the abscopal effect in a patient with melanoma.

            The abscopal effect is a phenomenon in which local radiotherapy is associated with the regression of metastatic cancer at a distance from the irradiated site. The abscopal effect may be mediated by activation of the immune system. Ipilimumab is a monoclonal antibody that inhibits an immunologic checkpoint on T cells, cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4). We report a case of the abscopal effect in a patient with melanoma treated with ipilimumab and radiotherapy. Temporal associations were noted: tumor shrinkage with antibody responses to the cancer-testis antigen NY-ESO-1, changes in peripheral-blood immune cells, and increases in antibody responses to other antigens after radiotherapy. (Funded by the National Institutes of Health and others.).
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              Whole body irradiation; radiobiology or medicine?

              R H MOLE (1953)
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                Author and article information

                Journal
                Case Rep Oncol
                Case Rep Oncol
                CRO
                CRO
                Case Reports in Oncology
                S. Karger AG (Basel, Switzerland )
                1662-6575
                8 November 2023
                Jan-Dec 2023
                8 November 2023
                : 16
                : 1
                : 1345-1352
                Affiliations
                [a ]Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
                [b ]Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
                [c ]Department of Clinical Oncology, Jichi Medical University Hospital, Tochigi, Japan
                [d ]Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, Tochigi, Japan
                Author notes
                Correspondence to: Masashi Endo, r1707em@ 123456jichi.ac.jp
                Article
                534609
                10.1159/000534609
                10631779
                37946746
                6e534154-e6cc-496c-886a-145d5e66c1d8
                © 2023 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) ( http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.

                History
                : 4 September 2023
                : 9 October 2023
                : 2023
                Page count
                Figures: 4, Tables: 1, References: 19, Pages: 8
                Funding
                This study was not supported by any sponsor or funder.
                Categories
                Case Report

                Oncology & Radiotherapy
                abscopal effect,head and neck squamous cell carcinoma,immunotherapy,stereotactic body radiotherapy

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