Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Dec;5(6):404-7.
doi: 10.1593/tlo.12280. Epub 2012 Dec 1.

A systemic complete response of metastatic melanoma to local radiation and immunotherapy

Susan M Hiniker  1 , Daniel S Chen, Sunil Reddy, Daniel T Chang, Jennifer C Jones, Joseph A Mollick, Susan M Swetter, Susan J Knox
Affiliations

A systemic complete response of metastatic melanoma to local radiation and immunotherapy

Susan M Hiniker et al. Transl Oncol. 2012 Dec.

Abstract

Background: Melanoma is a relatively immunogenic tumor, in which infiltration of melanoma cells by T lymphocytes is associated with a better clinical prognosis. We hypothesized that radiation-induced cell death may provide additional stimulation of an anti-tumor immune response in the setting of anti-CTLA-4 treatment.

Methods: In a pilot melanoma patient, we prospectively tested this hypothesis. We treated the patient with two cycles of ipilimumab, followed by stereotactic ablative radiotherapy to two of seven hepatic metastases, and two additional cycles of ipilimumab.

Results: Subsequent positron emission tomography-computed tomography scan indicated that all metastases, including unirradiated liver lesions and an unirradiated axillary lesion, had completely resolved, consistent with a complete response by RECIST.

Conclusion: The use of radiotherapy in combination with targeted immunotherapy as a noninvasive in vivo tumor vaccine strategy appears to be a promising method of enhancing the induction of systemic immune responses and anti-tumor effect.

PubMed Disclaimer

Figures

Figure 1
Figure 1
PET scans performed before treatment (row 1), at 6 months after treatment (row 2), and at 12 months after treatment (row 3). Column A (arrow) shows untreated axillary lesion that was no longer apparent at 6 and 12 months after treatment. Column B (arrow) shows one of two treated hepatic lesions, which showed complete response to treatment at 6 and 12 months after treatment. Column C (arrows) shows three of five untreated hepatic lesions, which also showed complete response to treatment at 6 and 12 months after treatment.
See this image and copyright information in PMC

References

    1. Postow MA, Callahan MK, Barker CA, Yamada Y, Yuan J, Kitano S, Mu Z, Rasalan T, Adamow M, Ritter E, et al. Immunologic correlates of the abscopal effect in a patient with melanoma. N Engl J Med. 2012;366(10):925–931. - PMC - PubMed
    1. Clemente CG, Mihm MC, Jr, Bufalino R, Zurrida S, Collini P, Cascinelli N. Prognostic value of tumor infiltrating lymphocytes in the vertical growth phase of primary cutaneous melanoma. Cancer. 1996;77(7):1303–1310. - PubMed
    1. Lenschow DJ, Walunas TL, Bluestone JA. CD28/B7 system of T cell costimulation. Annu Rev Immunol. 1996;14:233–258. - PubMed
    1. Walunas TL, Lenschow DJ, Bakker CY, Linsley PS, Freeman GJ, Green JM, Thompson CB, Bluestone JA. CTLA-4 can function as a negative regulator of T cell activation. Immunity. 1994;1(5):405–413. - PubMed
    1. Krummel MF, Sullivan TJ, Allison JP. Superantigen responses and co-stimulation: CD28 and CTLA-4 have opposing effects on T cell expansion in vitro and in vivo. Int Immunol. 1996;8(4):519–523. - PubMed

LinkOut - more resources