Abscopal effect and resistance reversion in nivolumab-treated non-small-cell lung cancer undergoing palliative radiotherapy: a case report

Abscopal effect has been mentioned for a long time, but only recently a deeper knowledge about underlying mechanisms supporting the interaction between immune system and radiation therapy became available. Furthermore, the introduction of immune-checkpoint inhibitors makes appealing the idea of combining them with radiotherapy (RT) to elicit abscopal effect and ideally revert an intrinsic or acquired resistance. Herein, we present the case of a non-small-cell lung cancer patient undergoing, during second line nivolumab, palliative RT on thoracic wall lesion, achieving a complete response in the metastatic adrenal site. This case report suggests that the abscopal effect exists in clinical practice of lung cancer care likely due to a synergism between immune-checkpoint and RT, even when administered with a palliative intent.