{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T07:56:09Z","timestamp":1780559769839,"version":"3.54.1"},"reference-count":16,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:00:00Z","timestamp":1733270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012537","name":"Ditmanson Medical Foundation Chia-Yi Christian Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012537","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Most abscopal effects are reported as sporadic and unpredictable events following radiotherapy at symptomatic sites. Herein, we report a case in which a planned abscopal effect was induced following deliberate radiotherapy and concurrent systemic immunotherapy. A 53-year-old man with a combined positive score \u226510 developed extensive metastatic bladder cancer after progressing on conventional chemotherapy. Extensive metastases were identified in his liver, lungs, and bones. He later had four cycles of single-agent pembrolizumab and planned hypofractionated radiotherapy at an ablative dose to selected metastatic lung tumors and developed complete remission of disease even when pembrolizumab was discontinued. This is a clear demonstration that the abscopal effect could be harnessed in a systematic manner with a combined positive score and aggressive local radiotherapy.<\/jats:p>","DOI":"10.3390\/curroncol31120573","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T09:30:18Z","timestamp":1733391018000},"page":"7787-7792","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Planned Abscopal Effect with Concurrent Pembrolizumab and Ablative Radiotherapy to Pulmonary Metastasis: A Case Report and Review of the Literature"],"prefix":"10.3390","volume":"31","author":[{"given":"Yu-Ting","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 60002, Taiwan"},{"name":"Department of Biomedical Sciences, National Chung Cheng University, Chiayi 62100, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-0884","authenticated-orcid":false,"given":"Chien-Chin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan"},{"name":"Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan 701401, Taiwan"},{"name":"Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan 717301, Taiwan"},{"name":"Ph.D. Program in Translational Medicine, Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 402202, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiya","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan 320314, Taiwan"},{"name":"Department of Radiation Oncology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 60002, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Chia","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 60002, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4535-2213","authenticated-orcid":false,"given":"Cheng-Yen","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 60002, Taiwan"},{"name":"Ph.D. Program in Advanced Manufacturing Systems, Advanced Institute of Manufacturing with High-tech Innovations, National Chung Cheng University, Chiayi 62100, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1056\/NEJMoa1613683","article-title":"Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma","volume":"376","author":"Bellmunt","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.ymthe.2017.11.011","article-title":"Irradiation Enhances Abscopal Anti-tumor Effects of Antigen-Specific Immunotherapy through Regulating Tumor Microenvironment","volume":"26","author":"Chang","year":"2018","journal-title":"Mol. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.it.2018.06.001","article-title":"Immunological Mechanisms Responsible for Radiation-Induced Abscopal Effect","volume":"39","author":"Melero","year":"2018","journal-title":"Trends Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.currproblcancer.2015.10.001","article-title":"Systematic review of case reports on the abscopal effect","volume":"40","author":"Abuodeh","year":"2016","journal-title":"Curr. Probl. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/S2213-2600(20)30391-X","article-title":"Pembrolizumab with or without radiotherapy for metastatic non-small-cell lung cancer: A pooled analysis of two randomised trials","volume":"9","author":"Theelen","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/s13045-018-0647-8","article-title":"Abscopal effect of radiotherapy combined with immune checkpoint inhibitors","volume":"11","author":"Liu","year":"2018","journal-title":"J. Hematol. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1007\/s00345-020-03440-4","article-title":"Combined radiotherapy and immunotherapy in urothelial bladder cancer: Harnessing the full potential of the anti-tumor immune response","volume":"39","author":"Kassouf","year":"2021","journal-title":"World J. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s13691-023-00606-w","article-title":"A long-term survival case of bladder cancer with distant metastases: Abscopal effect of brain metastases after stereotactic radiotherapy with immune checkpoint blockade therapy to lung metastases","volume":"12","author":"Kono","year":"2023","journal-title":"Int. Cancer Conf. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1002\/iju5.12133","article-title":"Possible abscopal effect in urothelial carcinoma of the upper urinary tract after treatment with immune checkpoint inhibitors","volume":"3","author":"Ishiyama","year":"2020","journal-title":"IJU Case Rep."},{"key":"ref_10","first-page":"85","article-title":"Abscopal effect in a patient with malignant pleural mesothelioma treated with palliative radiotherapy and pembrolizumab","volume":"27","author":"Mampuya","year":"2021","journal-title":"Clin. Transl. Radiat. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.semradonc.2019.12.008","article-title":"Priming and Propagating Anti-tumor Immunity: Focal Hypofractionated Radiation for in Situ Vaccination and Systemic Targeted Radionuclide Theranostics for Immunomodulation of Tumor Microenvironments","volume":"30","author":"Jagodinsky","year":"2020","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.semradonc.2019.12.004","article-title":"Effects of Radiation on the Tumor Microenvironment","volume":"30","author":"Monjazeb","year":"2020","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.semradonc.2019.12.007","article-title":"Combining Radiation with Immunotherapy: The University of Pennsylvania Experience","volume":"30","author":"Luo","year":"2020","journal-title":"Semin. Radiat. 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