title: A systemic complete response of metastatic melanoma to local radiation and immunotherapy.
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.
  
  
  CONCLUSIONS
  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.
authors: Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA.
authors: Susan M
authors: SM
authors: Hiniker
authors: Daniel S
authors: DS
authors: Chen
authors: Sunil
authors: S
authors: Reddy
authors: Daniel T
authors: DT
authors: Chang
authors: Jennifer C
authors: JC
authors: Jones
authors: Joseph A
authors: JA
authors: Mollick
authors: Susan M
authors: SM
authors: Swetter
authors: Susan J
authors: SJ
authors: Knox