Abscopal effect after hypofractionated radiotherapy in metastatic renal cell carcinoma pretreated with pazopanib

• Published in: Immunotherapy Vol. 12; no. 12; pp. 869 - 878
• Main Authors: Cerbone, Luigi, Rebuzzi, Sara Elena, Lattanzi, Elisabetta, Gnetti, Letizia, Iaia, Maria Laura, D’Abbiero, Nunziata, Buti, Sebastiano
• Format: Journal Article
• Language: English
• Published: London Future Medicine Ltd 01-08-2020
• Subjects: Abdomen; abscopal effect; Apoptosis; hypofractionated; Immunotherapy; Kidney cancer; Kinases; Ligands; Lung carcinoma; Lymph nodes; Lymphatic system; Lymphocytes; Medical imaging; MET; Metastases; Metastasis; mTOR pathway; Patients; pazopanib; PD-L1; Protein-tyrosine kinase; Radiation therapy; radiotherapy; Renal cell carcinoma; Targeted cancer therapy; Toxicity; Tumor microenvironment; tumor-infiltrating lymphocytes; Tumors
• ISSN: 1750-743X; 1750-7448
• DOI: 10.2217/imt-2020-0072

The abscopal effect consists of distant metastases response after local treatment based on systemic immune stimulation. It is a rare event observed in many tumors, especially with radiotherapy and immunotherapy.
We report the long-term abscopal effect in a metastatic renal cell carcinoma patient with lung metastasectomy, after hypofractionated radiotherapy on lymph node metastasis. The patient was pretreated with pazopanib, which was discontinued early owing to toxicity before radiotherapy.
Immunohistological analyses of the primary tumor and metastases were performed.
We supposed that radiotherapy, and maybe tyrosine kinase inhibitors, could act as immune-primers for abscopal effect modifying the immune tumor microenvironment.
Future studies are needed to optimize the combination of radiotherapy with systemic therapy for better long-term tumor control in selected patients.