Universität zu Köln

Ferdinandus, Simone ORCID: 0000-0002-0361-728X, Rühle, Alexander, Lamrani, Allison, Frei, Charlotte, Kaufmann, Justus ORCID: 0000-0003-0189-3499, Mäurer, Matthias, Wurschi, Georg, Jiang, Ping, Ehret, Felix ORCID: 0000-0001-6177-1755, Baehr, Andrea, Hardt, Annika, Bodensohn, Raphael, Käsmann, Lukas, Waltenberger, Maria, Scafa, Davide, Layer, Julian P, Troost, Esther G C, Elkhamisy, Sally A, Jazmati, Danny, Franklin, Cindy ORCID: 0000-0001-9142-5423, Neppl, Sebastian, Hagemeier, Anna and Trommer, Maike ORCID: 0000-0003-2864-4273 (2025). Abscopal effects in patients with malignant melanoma treated with radiotherapy and immune checkpoint inhibition: analysis of a large observational multicenter study. Journal for ImmunoTherapy of Cancer, 13 (10). pp. 1-12. BMJ Group. ISSN 2051-1426

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Abstract

[Artikel-Nr. e012717] Background: Abscopal effect (AbE), the regression of non-irradiated metastatic lesions (NILs) following radiotherapy (RT), is relevant in patients with malignant melanoma (MM) with progressive disease (PD) under immune checkpoint inhibition (ICI) as resistance to immunotherapy. In the “ARTIC” trial, we assessed the incidence of AbE in patients with progressive MM by evaluating the effect of RT on NILs. Methods: ARTIC ( A bscopal effects in metastasized cancer patients treated with R adio T herapy and I mmune C heckpoint inhibition) (ARO (Arbeitsgemeinschaft Radiologische Onkologie) 2022–10, DRKS00032390) retrospectively screened clinical records of patients with stage IV MM with PD under ICI. Patients received RT for metastases and had ≥1 NIL outside the RT field (=control lesion). NILs were evaluated according to iRECIST (immune Response Evaluation Criteria in Solid Tumors): abscopal response (AR): size reduction ≥30%, abscopal progression (AP): size increase ≥20%, abscopal control (AC): all others. Patients with AR and/or AC were categorized as abscopal benefit (AB), patients with AP and/or mixed response=no AB. RT details and factors influencing AR were analyzed. Results: After screening clinical records of 3773 patients with stage IV tumor from 12 oncological centers in Germany, we identified 47 patients with MM with 115 NILs. RT targeted metastases in brain (38.3%) and lung (19.1%), primarily using stereotactic RT (29.8%). The mean time interval between the end of ICI and RT was 3.53±5.67 months. AR was achieved in 19.1% of patients and 29.1% of lesions. Compared with stereotactic RT, normofractionated or other (non-stereotactic) RT regimens significantly reduced the probability of AB (OR=0.092, p=0.04, 95% CI: (0.007 to 0.758)). Longer ICI-to-RT intervals were associated with reduced mortality risk (HR=0.703, p=0.007, 95% CI: (0.544 to 0.908)). Patients with AB had a longer median overall (17 vs 9 months) and a longer median progression-free survival (4 vs 2 months). Conclusions: RT can induce AR in patients with MM with PD under ICI, particularly with hypofractionated regimens and long ICI-to-RT intervals. Our findings can serve as a reference for designing prospective trials

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Ferdinandus, Simone UNSPECIFIED https://orcid.org/0000-0002-0361-728X UNSPECIFIED Rühle, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Lamrani, Allison UNSPECIFIED UNSPECIFIED UNSPECIFIED Frei, Charlotte UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaufmann, Justus UNSPECIFIED https://orcid.org/0000-0003-0189-3499 UNSPECIFIED Mäurer, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Wurschi, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Jiang, Ping UNSPECIFIED UNSPECIFIED UNSPECIFIED Ehret, Felix UNSPECIFIED https://orcid.org/0000-0001-6177-1755 UNSPECIFIED Baehr, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Hardt, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Bodensohn, Raphael UNSPECIFIED UNSPECIFIED UNSPECIFIED Käsmann, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Waltenberger, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Scafa, Davide UNSPECIFIED UNSPECIFIED UNSPECIFIED Layer, Julian P UNSPECIFIED UNSPECIFIED UNSPECIFIED Troost, Esther G C UNSPECIFIED UNSPECIFIED UNSPECIFIED Elkhamisy, Sally A UNSPECIFIED UNSPECIFIED UNSPECIFIED Jazmati, Danny UNSPECIFIED UNSPECIFIED UNSPECIFIED Franklin, Cindy UNSPECIFIED https://orcid.org/0000-0001-9142-5423 UNSPECIFIED Neppl, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagemeier, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Trommer, Maike UNSPECIFIED https://orcid.org/0000-0003-2864-4273 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-798361
Identification Number:	10.1136/jitc-2025-012717
Journal or Publication Title:	Journal for ImmunoTherapy of Cancer
Volume:	13
Number:	10
Page Range:	pp. 1-12
Number of Pages:	1
Date:	2 October 2025
Publisher:	BMJ Group
ISSN:	2051-1426
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Strahlentherapie > Klinik und Poliklinik für Radioonkologie, Cyberknife- und Strahlentherapie
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79836