{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T19:03:33Z","timestamp":1792263813437,"version":"4.4.0"},"reference-count":45,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2025,9,15]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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 \u201cARTIC\u201d trial, we assessed the incidence of AbE in patients with progressive MM by evaluating the effect of RT on NILs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      ARTIC (\n                      <jats:underline>A<\/jats:underline>\n                      bscopal effects in metastasized cancer patients treated with\n                      <jats:underline>R<\/jats:underline>\n                      adio\n                      <jats:underline>T<\/jats:underline>\n                      herapy and\n                      <jats:underline>I<\/jats:underline>\n                      mmune\n                      <jats:underline>C<\/jats:underline>\n                      heckpoint inhibition) (ARO (Arbeitsgemeinschaft Radiologische Onkologie) 2022\u201310, DRKS00032390) retrospectively screened clinical records of patients with stage IV MM with PD under ICI. Patients received RT for metastases and had \u22651\u2009NIL outside the RT field (=control lesion). NILs were evaluated according to iRECIST (immune Response Evaluation Criteria in Solid Tumors): abscopal response (AR): size reduction \u226530%, abscopal progression (AP): size increase \u226520%, 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u00b15.67 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%\u2009CI: (0.007 to 0.758)). Longer ICI-to-RT intervals were associated with reduced mortality risk (HR=0.703, p=0.007, 95%\u2009CI: (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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jitc-2025-012717","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T06:55:24Z","timestamp":1759474524000},"page":"e012717","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Abscopal effects in patients with malignant melanoma treated with radiotherapy and immune checkpoint inhibition: analysis of a large observational multicenter study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0361-728X","authenticated-orcid":false,"given":"Simone","family":"Ferdinandus","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Cyberknife and Radiotherapy, University Hospital Cologne, Cologne, Germany"},{"name":"University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, CIO ABCD, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"R\u00fchle","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany"},{"name":"Department of Radiation Oncology, University of Leipzig Medical Center, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Lamrani","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Frei","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0189-3499","authenticated-orcid":false,"given":"Justus","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"M\u00e4urer","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Jena University Hospital, Jena, Germany"},{"name":"Clinician Scientist Program OrganAge, Jena University Hospital, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Wurschi","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Jena University Hospital, Jena, Germany"},{"name":"Clinician Scientist Program, Interdisciplinary Center for Clinical Research (IZKF), Jena University Hospital, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Jiang","sequence":"additional","affiliation":[{"name":"Clinic for Radiation Oncology and Radiotherapy, Luedenscheid Clinic, Luedenscheid, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6177-1755","authenticated-orcid":false,"given":"Felix","family":"Ehret","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"German Cancer Consortium (DKTK), partner site Berlin, a partnership between DKFZ and Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"K\u00e4smann","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Waltenberger","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Hospital of Bolzano (SABES-ASDAA); Teaching Hospital of Paracelsus Meodical University Salzburg, Salzburg, Austria, Bolzano-Bozen, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Scafa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian P","family":"Layer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany"},{"name":"Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther G C","family":"Troost","sequence":"additional","affiliation":[{"name":"OncoRay \u2013 National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany"},{"name":"Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally A","family":"Elkhamisy","sequence":"additional","affiliation":[{"name":"OncoRay \u2013 National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany"},{"name":"Department of 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