Abscopal effects in patients with malignant melanoma treated with radiotherapy and immune checkpoint inhibition: analysis of a large observational multicenter study

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Simone Ferdinandus - , Universität zu Köln (Autor:in)
  • Alexander Rühle - , Universitätsklinikum Freiburg, Universität Leipzig (Autor:in)
  • Allison Lamrani - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Charlotte Frei - , Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Justus Kaufmann - , Universitätsmedizin Mainz (Autor:in)
  • Matthias Mäurer - , Friedrich-Schiller-Universität Jena (Autor:in)
  • Georg Wurschi - , Friedrich-Schiller-Universität Jena (Autor:in)
  • Ping Jiang - , Klinikum Lüdenscheid (Autor:in)
  • Felix Ehret - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Andrea Baehr - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Annika Hardt - , Universität Hamburg (Autor:in)
  • Raphael Bodensohn - , Ludwig-Maximilians-Universität München (LMU), Universitätsklinikum Tübingen (Autor:in)
  • Lukas Käsmann - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Maria Waltenberger - , Regional Hospital of Bolzano, Paracelsus Medizinischen Privatuniversität (Autor:in)
  • Davide Scafa - , Universität Bonn (Autor:in)
  • Julian P. Layer - , Universität Bonn (Autor:in)
  • Esther G.C. Troost - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie, OncoRay - Nationales Zentrum für Strahlenforschung in der Onkologie (Autor:in)
  • Sally A. Elkhamisy - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie, OncoRay - Nationales Zentrum für Strahlenforschung in der Onkologie (Autor:in)
  • Danny Jazmati - , Universitätsklinikum Düsseldorf (Autor:in)
  • Cindy Franklin - , Universität zu Köln (Autor:in)
  • Sebastian Neppl - , Universität zu Köln (Autor:in)
  • Anna Hagemeier - , Universität zu Köln (Autor:in)
  • Maike Trommer - , Universität zu Köln, Universität Bonn (Autor:in)

Abstract

Background Abscopal effect (AbE), the regression of non-irradiated metastatic lesions (NILs) following radiotherapy (RT), is relevant in patients with malignant melanoma (MM) with progressive disease (PD) under immune checkpoint inhibition (ICI) as resistance to immunotherapy. In the “ARTIC” trial, we assessed the incidence of AbE in patients with progressive MM by evaluating the effect of RT on NILs. Methods ARTIC (<ani:underline>A</ani:underline>bscopal effects in metastasized cancer patients treated with <ani:underline>R</ani:underline>adio<ani:underline>T</ani:underline>herapy and <ani:underline>I</ani:underline>mmune <ani:underline>C</ani:underline>heckpoint inhibition) (ARO (Arbeitsgemeinschaft Radiologische Onkologie) 2022–10, DRKS00032390) retrospectively screened clinical records of patients with stage IV MM with PD under ICI. Patients received RT for metastases and had ≥1NIL outside the RT field (=control lesion). NILs were evaluated according to iRECIST (immune Response Evaluation Criteria in Solid Tumors): abscopal response (AR): size reduction ≥30%, abscopal progression (AP): size increase ≥20%, abscopal control (AC): all others. Patients with AR and/or AC were categorized as abscopal benefit (AB), patients with AP and/or mixed response=no AB. RT details and factors influencing AR were analyzed. Results After screening clinical records of 3773 patients with stage IV tumor from 12 oncological centers in Germany, we identified 47 patients with MM with 115 NILs. RT targeted metastases in brain (38.3%) and lung (19.1%), primarily using stereotactic RT (29.8%). The mean time interval between the end of ICI and RT was 3.53±5.67 months. AR was achieved in 19.1% of patients and 29.1% of lesions. Compared with stereotactic RT, normofractionated or other (non-stereotactic) RT regimens significantly reduced the probability of AB (OR=0.092, p=0.04, 95%CI: (0.007 to 0.758)). Longer ICI-to-RT intervals were associated with reduced mortality risk (HR=0.703, p=0.007, 95%CI: (0.544 to 0.908)). Patients with AB had a longer median overall (17 vs 9 months) and a longer median progression-free survival (4 vs 2 months). Conclusions RT can induce AR in patients with MM with PD under ICI, particularly with hypofractionated regimens and long ICI-to-RT intervals. Our findings can serve as a reference for designing prospective trials.

Details

OriginalspracheEnglisch
Aufsatznummere012717
FachzeitschriftJournal for immunotherapy of cancer
Jahrgang13
Ausgabenummer10
PublikationsstatusVeröffentlicht - 2 Okt. 2025
Peer-Review-StatusJa

Externe IDs

PubMed 41043856

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Abscopal, Immune modulatory, Immunotherapy, RADIOTHERAPY, Solid tumor