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Rare medical phenomenon of systemic tumor disappearance following local radiation treatment reported in a patient with metastatic melanoma
Date:3/7/2012

nistration. Over time the patient's melanoma slowly grew in the spleen, lymph nodes, and an area near the spine. When the disease progressed, the patient received localized radiation therapy to the melanoma tumor near the spine to help with pain relief. After the radiation treatment, the targeted tumor near the patient's spine shrank significantly. Unexpectedly, other areas where the melanoma had spread (the spleen and the lymph nodes) but that were not directly targeted by the radiation therapy also benefited, consistent with the abscopal effect. The patient continues to do well more than one year since receiving the radiation therapy.

Scientists are not certain how the abscopal effect works to eliminate cancer in patients. Studies in mice suggest that the effect may depend upon activation of the immune system. In the case study reported by Dr. Wolchok and colleagues at Memorial Sloan Kettering, changes in the patient's immune system were measured over the course of treatment. The team observed changes in tumor-directed antibody levels and immune cell populations that occurred at the time of the abscopal effect. These findings support the idea that radiation may help stimulate the immune system to fight cancer.

Ipilimumab is an immunotherapy that exploits the body's own immune system to attack cancer. It was approved by the FDA in March of 2011 and is the first drug ever to show an improvement in overall survival for patients with advanced melanoma. The therapy blocks a target called CTLA-4 and was developed by James Allison, PhD, Chair of the Sloan Kettering Institute's Immunology Program.

This patient's dramatic response provides new insight into how radiation may help activate the immune system to fight cancer and suggests novel therapeutic avenues to pursue. Clinical trials are under way now to validate the approach of combining radiation therapy with ipilimumab for the treatment of melanoma and prostate cancer.


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Contact: Jeanne D'Agostino
dagostij@mskcc.org
212-639-3573
Memorial Sloan-Kettering Cancer Center
Source:Eurekalert

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