Influence of low-dose radiation on abscopal responses in patients receiving high-dose radiation and immunotherapy
Barsoumian, Hampartsoum B
Cushman, Taylor R
Younes, Ahmed I
Cortez, Maria A
Erasmus, Jeremy J
de Groot, Patricia
Carter, Brett W
Hong, David S
Glitza, Isabella C
Chun, Stephen G
Heymach, John V
Nguyen, Quynh N
Welsh, James W
AffiliationUniv Arizona, Coll Med
Stereotactic ablative radiation therapy
MetadataShow full item record
CitationMenon, H., Chen, D., Ramapriyan, R., Verma, V., Barsoumian, H. B., Cushman, T. R., ... & Carter, B. W. (2019). Influence of low-dose radiation on abscopal responses in patients receiving high-dose radiation and immunotherapy. Journal for immunotherapy of cancer, 7(1), 237.
RightsCopyright © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractBackground Preclinical evidence suggests that low-dose radiation may overcome the inhibitory effects of the tumor stroma and improve a tumor's response to immunotherapy, when combined with high-dose radiation to another tumor. The aim of this study was to evaluate tumor responses to this combination in a clinical setting. Methods A post-hoc analysis of 3 ongoing immunoradiation trials was performed. Twenty-six (of 155) patients received low-dose radiation (1-20 Gy total), either as scatter from high-dose radiation or from intentional treatment of a second isocenter with low-dose radiation, were evaluated for response. The low-dose lesions were compared to lesions that received no radiation (< 1 Gy total). Response rates, both defined as complete and partial responses as defined by RECIST criteria were used to compare lesion types. Results The 26 patients had a total of 83 lesions for comparison (38 receiving low-dose, 45 receiving no-dose). The average dose given to low-dose lesions was 7.3 Gy (1.1-19.4 Gy), and the average time to response was 56 days. Twenty-two out of 38 (58%) low-dose lesions met the PR/CR criteria for RECIST compared with 8 out of 45 (18%) no-dose lesions (P = 0.0001). The median change for longest diameter size for low-dose lesions was - 38.5% compared to 8% in no-dose lesions (P < 0.0001). Among the low-dose lesions that had at least one no-dose lesion within the same patient as a control (33 and 45 lesions respectively), 12 low-dose lesions (36%) responded without a corresponding response in their no-dose lesions; Conversely, two (4%) of the no-dose lesions responded without a corresponding response in their low-dose lesion (P = 0.0004). Conclusions Low-dose radiation may increase systemic response rates of metastatic disease treated with high-dose radiation and immunotherapy.
NoteOpen access journal
VersionFinal published version
SponsorsVarian; Bristol-Myers Squibb; Merck & Company
- Local tumor response and survival outcomes after combined stereotactic radiosurgery and immunotherapy in non-small cell lung cancer with brain metastases.
- Authors: Singh C, Qian JM, Yu JB, Chiang VL
- Issue date: 2019 Feb 15
- Overall survival according to immunotherapy and radiation treatment for metastatic non-small-cell lung cancer: a National Cancer Database analysis.
- Authors: Foster CC, Sher DJ, Rusthoven CG, Verma V, Spiotto MT, Weichselbaum RR, Koshy M
- Issue date: 2019 Jan 28
- Absolute Lymphocyte Count Predicts Abscopal Responses and Outcomes in Patients Receiving Combined Immunotherapy and Radiation Therapy: Analysis of 3 Phase 1/2 Trials.
- Authors: Chen D, Verma V, Patel RR, Barsoumian HB, Cortez MA, Welsh JW
- Issue date: 2020 Sep 1
- Lymphopenia predicts response to stereotactic radiosurgery in lung cancer patients with brain metastases.
- Authors: Li YD, Lamano JB, Kaur G, Lamano JB, Veliceasa D, Biyashev D, Kruser T, Bloch O
- Issue date: 2019 Jun
- Phase II Trial of Ipilimumab with Stereotactic Radiation Therapy for Metastatic Disease: Outcomes, Toxicities, and Low-Dose Radiation-Related Abscopal Responses.
- Authors: Welsh JW, Tang C, de Groot P, Naing A, Hess KR, Heymach JV, Papadimitrakopoulou VA, Cushman TR, Subbiah V, Chang JY, Simon GR, Ramapriyan R, Barsoumian HB, Menon H, Cortez MA, Massarelli E, Nguyen Q, Sharma P, Allison JP, Diab A, Verma V, Raju U, Shaaban SG, Dadu R, Cabanillas ME, Wang K, Anderson C, Gomez DR, Hahn S, Komaki R, Hong DS
- Issue date: 2019 Dec