Combination therapy may work due to the “abscopal effect,” where a patient experiences regression of metastatic cancer distant from the site of local radiation, possibly a systemic response, said Dr. Sunwoo. He shared a case of a female patient with melanoma who had a growing paraspinal mass and high levels of pain. She started ipilimumab therapy, but her cancer slowly progressed. Once she started a combination therapy of radiation and ipilimumab, her cancer responded, and she progressed to stable disease.
Explore This IssueNovember 2018
This led to a new trial at Stanford of ipilimumab and radiation in Stage IV melanoma. So far there have been three complete and three partial responders, and five stable patients, he said. Mass cytometry revealed potentially predictive markers for positive response: Responders had higher central-memory T cells that express IL-2. Research in this area may point the way to more effective treatment of patients with aggressive head and neck cancers, the panel concluded.
Susan Bernstein is a freelance medical writer based in Georgia.