Extracranial abscopal effect induced by combining immunotherapy with brain radiotherapy in a patient with lung adenocarcinoma: A case report and literature review

Thorac Cancer. 2019 May;10(5):1272-1275. doi: 10.1111/1759-7714.13048. Epub 2019 Mar 30.

Abstract

An extracranial abscopal effect induced by brain radiotherapy is particularly unusual because of the brain's distinctive immune microenvironment. We report a case of an extracranial abscopal effect in a 71-year-old male patient with lung adenocarcinoma treated with atezolizumab and later combined with brain radiation for brain metastasis. The subsequent abscopal effect first manifested as pseudoprogression of the primary lesion in the lung before remission was confirmed. This case suggests that immunotherapy increases the chance of an abscopal effect occurring after radiation therapy for brain metastases in patients with primary tumors with low immunogenicity.

Keywords: Abscopal effect; brain metastasis; immunotherapy; lung cancer; radiation therapy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenocarcinoma of Lung / diagnosis
  • Adenocarcinoma of Lung / pathology*
  • Adenocarcinoma of Lung / therapy
  • Aged
  • Antineoplastic Agents, Immunological / therapeutic use
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / therapy*
  • Combined Modality Therapy
  • Humans
  • Immunotherapy*
  • Magnetic Resonance Imaging / methods
  • Male
  • Radiosurgery
  • Radiotherapy, Adjuvant* / methods
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological