A case of PD-1 targeting drugs + radiation

[Jorge]

A case of PD-1 targeting drugs + radiation of A Chinese patient. Here is the info of this case:
before PD-1: lung 6cm, Liver 5+cm, pancreas 6cm
Best response: Lung 0.7cm, Liver 1cm.
Developed resistance to PD-1, Oct ~Dec 2017: lung 20% increase. pancreas 5cm (intensity modulated radiation therapy, 45gy/25days)
Mar 2018: Lung 1.7cm, Liver 5.2, pancreas 1.5cm
Now: Lung 3.4cm, Liver 6.4, pancreas clear.

The interesting thing of this patient is, he had intensity modulated radiation therapy to the pancreas met after he developed resistance to PD-1. the radiation didn't cause abscopal immuno response, but the treated met response very well and disappear.
I think we should add this to the immuno treatment--even if someone seem doesn't response to immunotherapy, radiation can work better on the treated met. In this case, all the big mets can be treated to reduce the tumors.

[D.ap]

Lynette
This is truly amazing !
I agree certainly in reducing tumor load .
The above patient had abdominal tumors ( and the lung) the size of Joshua’s primary almost , huh..

So how long were they off Keytruda , when the IMRT was performed ?

They were on Keytruda 3 months or ? ,and saw 20% increase? Resistance developement of psncrease tumor? Then discontinued?
I sure wish the best for this patient .

[D.ap]

Also Lynette
Don’t want to hog your post (LOL) but what are this persons next plans for a Med ?

This ici wasn’t their first line of a Med , right ?

Is it possible to take Keytruda( or another ICI) again , after elimination of the rather large pancreas tumor and adding IMRT( and or another modulation type radiation therapy ) while on Keytruda to see if the abscopal effect could be produced ?