title: Abscopal Effects: Case Report and Emerging Opportunities.
abstract: The abscopal effect is a phenomenon observed in the treatment of metastatic cancer where localized irradiation of a particular tumor site causes a response in a site distant to the irradiated volume. The mechanisms of the abscopal effect are speculated to be of several origins, including distant effects on p53, elaboration of inflammatory agents including cytokines, and, most recently, secondary to immune mechanisms. In this case report, we present a rare report of a patient with hepatocellular carcinoma with lung metastases who, after receiving radiation treatment to the liver, had a treatment response in the liver and a complete response in the lung. Recent advances in the understanding of the primary role of immune-modulated cytotoxicity, especially with the success of immune checkpoint inhibitors, have the potential to turn the abscopal effect from a rare phenomenon into a tool to guide antineoplastic therapy and provide a new line of research.
authors.affiliation: Department of Radiation Oncology, London Regional Cancer Program, London, Ontario, CA; Schulich School of Medicine & Dentistry, Western University, London, Ontario, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lock
authors.affiliation: Oncology, Trillium Health Partners.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Muinuddin
authors.affiliation: Oncology, London Health Sciences Centre.
authors.forename: Walter I
authors.initials: WI
authors.lastname: Kocha
authors.affiliation: Cancer Clinical Research Unit (CCRU), Princess Margaret Cancer Centre.
authors.forename: Robert
authors.initials: R
authors.lastname: Dinniwell
authors.affiliation: Department of Radiation Oncology, London Regional Cancer Program, London, Ontario, CA; Schulich School of Medicine & Dentistry, Western University, London, Ontario, CA.
authors.forename: George
authors.initials: G
authors.lastname: Rodrigues
authors.affiliation: Department of Radiation Oncology, London Regional Cancer Program, London, Ontario, CA; Schulich School of Medicine & Dentistry, Western University, London, Ontario, CA.
authors.forename: David
authors.initials: D
authors.lastname: D'souza
keywords: abscopal effect; immune checkpoint inhibitors; immunomodulation; liver cancer; lung metastases; lung tumors; radiotherapy; sbrt; spontaneous regression