• Journal of Gastric Cancer
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• v.21 no.3
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• pp.319-324
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• 2021

The abscopal effect refers to the phenomenon in which local radiotherapy is associated with the regression of metastatic cancer that is distantly located from the irradiated site. Here, we present a case of a patient with advanced gastric cancer and brain metastases who was successfully treated with brain radiotherapy and anti-programmed death-1 (PD-1) therapy-induced abscopal effect. Although anti-PD-1 therapy alone could not prevent disease progression, the metastatic lesions in the brain and also in the abdominal lymph node showed a drastic response after brain radiotherapy and anti-PD-1 therapy. To our knowledge, this is the first reported case of successful treatment of advanced gastric cancer with multiple brain and abdominal lymph node metastases, possibly through anti-PD-1 therapy combined with brain radiotherapy-induced abscopal effect. We suggest that the combination of brain radiotherapy and anti-PD-1 therapy may be considered as a therapeutic option for advanced gastric cancer, especially when there is brain metastasis.

• Radiation Oncology Journal
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• v.37 no.4
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• pp.302-308
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• 2019

The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

• Biomedical Science Letters
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• v.29 no.4
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• pp.376-381
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• 2023

Abscopal effect is a form of secondary immune response that occurs in ionizing radiation therapy, resulting in changes in the immune response through activation of immune cells such as macrophages and T lymphocytes. UVB causes DNA damage similar to ionizing radiation and causes similar intracellular reactions, so it is often used as an alternative in research on the effects of ionizing radiation. In a previous study, we found that pro-inflammatory cytokines, including TNF-α, increased in Jurkat T cells exposed to TGs. In this study, we confirmed the effects of UVB irradiation on T lymphocytes exposed to TGs, similar to the effects of ionizing radiation. As a result, it was shown that the mRNA expression of pro-inflammatory cytokines such as IL-1β and IFN-γ in Jurkat T cells exposed to TGs increased by UVB irradiation. In addition, it was confirmed that the increase in the expression of pro-inflammatory cytokines caused by UVB was caused by the activation of iNOS protein. This is very similar to the immune response that occurs when T lymphocytes are exposed to TGs. These results suggest that activation of iNOS protein is involved in the increase in pro-inflammatory cytokines caused by UVB irradiation in T lymphocytes exposed to TGs.