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Anti-PD-1 monoclonal antibody-resistant esophageal squamous cell carcinoma showing the abscopal effect: A case report with T-cell receptor/B-cell receptor repertoire analysis
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  • Yuka Takehara,
  • Yoshiyuki Suzuki,
  • Kousaku Mimura,
  • Yuya Yoshimoto,
  • Yohei Watanabe,
  • Zenichiro Saze,
  • Hisashi Sato,
  • Tomoaki Tamaki,
  • Koji Kono
Yuka Takehara
Fukushima Medical University School of Medicine
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Yoshiyuki Suzuki
Fukushima Medical University School of Medicine

Corresponding Author:[email protected]

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Kousaku Mimura
Fukushima Medical University
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Yuya Yoshimoto
Fukushima Medical University School of Medicine
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Yohei Watanabe
Fukushima Medical University School of Medicine
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Zenichiro Saze
Fukushima Medical University School of Medicine
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Hisashi Sato
Fukushima Medical University School of Medicine
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Tomoaki Tamaki
Fukushima Medical University School of Medicine
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Koji Kono
Fukushima Medical University School of Medicine
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Abstract

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.
16 Jan 2023Submitted to Cancer Reports
18 Jan 2023Submission Checks Completed
18 Jan 2023Assigned to Editor
18 Jan 2023Review(s) Completed, Editorial Evaluation Pending
19 Jan 2023Reviewer(s) Assigned
09 Feb 2023Editorial Decision: Revise Major
20 Mar 20231st Revision Received
22 Mar 2023Assigned to Editor
22 Mar 2023Submission Checks Completed
22 Mar 2023Review(s) Completed, Editorial Evaluation Pending
22 Mar 2023Reviewer(s) Assigned
05 Apr 2023Editorial Decision: Revise Minor
19 Apr 20232nd Revision Received
21 Apr 2023Assigned to Editor
21 Apr 2023Submission Checks Completed
21 Apr 2023Review(s) Completed, Editorial Evaluation Pending
29 Apr 2023Editorial Decision: Accept