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.
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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
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