The radio-immunization effects of radiotherapy with abscopal tumor
regressions have been documented in several experimental and clinical
studies. Here, we present a patient with bladder cancer and relapsed
metastatic disease to the left supraclavicular/axillary area and left
lung. Concurrent weekly hypofractionated radiotherapy of both areas
(8Gy/fraction/week, four fractions in total) and bi-weekly immunotherapy
with anti-programmed cell death protein 1 (anti-PD-1) monoclonal
antibodies resulted in complete regression of the axillary metastatic
masses and of the lung metastasis, three months after the onset of
therapy. In CT scans, however, a sternum infiltrating mass growing
proximal to the margins of the radiotherapy fields was strikingly
evident, while multiple hepatic metastases also appeared. Lymphopenia
during radio-immunotherapy was recorded. The current report does not
confirm the abscopal effects of radio-immunotherapy and furthermore,
suggests that progressive disease or even hyper-rogression may occur in
a subgroup of patients. Although radio-vaccination is a well-established
phenomenon, it is evident that we still miss major aspects of host/
tumor-immune interactions with radiation
