Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA.
Transl Oncol. 2012 Dec;5(6):404-7. doi: 10.1593/tlo.12280. Epub 2012 Dec 1.
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.
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.
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.
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.
黑色素瘤是一种相对免疫原性的肿瘤，其中 T 淋巴细胞浸润黑色素瘤细胞与更好的临床预后相关。我们假设，在抗 CTLA-4 治疗的情况下，辐射诱导的细胞死亡可能为抗肿瘤免疫反应提供额外的刺激。
在一名黑色素瘤患者中，我们前瞻性地测试了这一假设。我们用两个周期的伊匹单抗治疗患者，然后对七个肝转移灶中的两个进行立体定向消融放疗，再用两个周期的伊匹单抗治疗。
随后的正电子发射断层扫描-计算机断层扫描表明，所有转移灶，包括未放疗的肝脏病变和未放疗的腋窝病变，均已完全消退，符合 RECIST 的完全缓解标准。
将放射治疗与靶向免疫治疗相结合作为一种非侵入性的体内肿瘤疫苗策略，似乎是一种很有前途的增强全身免疫反应和抗肿瘤效果的方法。
