Please note: We are currently experiencing some performance issues across the site, and some pages may be slow to load. We are working on restoring normal service soon. Importing new articles from Word documents is also currently unavailable. We apologize for any inconvenience.

Yuka Takehara

and 8 more

Background Several good results of clinical trial of nivolumab or involving nivolumab in advanced esophageal squamous cell carcinoma were reported. However, the response rate was still poor. A rare phenomenon called the “abscopal effect” refers to the regression of not only the irradiated tumor but also non-irradiated distant tumors after local radiotherapy. The mechanism is not completely clear, but it is thought that the activation of anti-tumor immunity induced by radiotherapy is the main factor. Case A 66-year-old man with recurred and nivolumab resistant esophageal squamous cell carcinoma in left-side cervical and abdominal para-aortal lymph node metastasis was treated with a total of 40 Gy (10 fractions) of radiotherapy to the left-side cervical lymph node metastasis which caused neck pain as a palliative treatment. Nivolumab was resumed the day after completion of radiotherapy. At 3 months after radiotherapy showed that the irradiated lesion in the left neck had regressed to a scar-like appearance. Notably, the abdominal para-aortal lymph nodes outside the irradiation area, which had previously tended to progress, had also shrunk (abscopal effect). The T cell receptor and B cell receptor (TCR/BCR) repertoire analysis before and after radiotherapy revealed that radiotherapy caused the changes in the TCR/BCR repertoire. Conclusion Changes in the TCR/BCR receptor repertoire repertoires were assumed to be a part of the mechanism of the abscopal effect. The findings in this patient suggest that combination of immune checkpoint inhibitors and radiotherapy can be a promising treatment approach, even for patients with immune checkpoint inhibitors resistant cancer.