Dr. Charles G. Drake of New York Presbyterian/Columbia University Medical Center, discusses the rare but intriguing abscopal effect.
Dr. Charles Drake says: There was an article in the New England Journal of Medicine showing an abscopal response with Yervoy (ipilimumab) anti-CTLA-4 in a patient with melanoma. It was a beautifully done paper with nice immunological correlates. After that got published, we found that radiation oncologists and medical oncologists were giving people a combination of immunotherapy and radiation and were telling patients they would get abscopal responses. But that’s a bit overly ambitious. In the clinic, it’s not that easy. It’s going to be a while before we understand what’s needed therapeutically to be able to induce abscopal responses in the majority of patients. It’s going to take a little more work before we can have that happen broadly. On the other hand, if we can make it work, it’ll be fantastic. Dr. Hammers’ trial combining anti- PD-1, anti-CTLA-4, and radiation in kidney cancer is perhaps a more clever approach. That may be what we need to do.
In other words, abscopal responses do happen, but we don’t exactly know why or how and can’t reproduce it?
Dr. Drake: Exactly. And it doesn’t happen nearly as often as we’d like.