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Article

Combination of immune checkpoint inhibitors and radiotherapy for bone metastases induces an abscopal effect and improves outcomes in non‑small cell lung cancer

  • Authors:
    • Yohei Asano
    • Katsuhiro Hayashi
    • Shinji Miwa
    • Yuta Taniguchi
    • Miho Okuda
    • Isao Matsumoto
    • Seiji Yano
    • Satoru Demura
  • View Affiliations / Copyright

    Affiliations: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan, Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8640, Japan, Department of Thoracic Surgery, Kanazawa University, Kanazawa, Ishikawa 920‑8640, Japan, Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Ishikawa 920‑8641, Japan
  • Article Number: 524
    |
    Published online on: September 15, 2025
       https://doi.org/10.3892/ol.2025.15270
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Abstract

The combination of immune checkpoint inhibitors (ICIs) and radiotherapy (RT) improves outcomes in non‑small cell lung cancer (NSCLC). However, the potential abscopal effect of RT for bone metastases (BoMs) remains unclear. The present retrospective study aimed to evaluate the impact of RT for BoMs on lung lesion response and survival in patients with NSCLC receiving ICIs. A total of 108 patients with NSCLC with BoMs treated with ICIs between March 2016 and January 2024 were included and divided into two groups based on whether they received RT for BoMs. Primary outcomes included the lung lesion response rate, overall survival (OS), progression‑free survival (PFS) and incidence of immune‑related adverse events (irAEs). Among 33 patients who received RT for BoM (RT‑BoM group), the dose/fraction ranged from 2 to 8 Gy/1 to15 fx (total 8‑39 Gy). The lung lesion response rate was significantly higher in the RT‑BoM group than in the non‑RT‑BoM group (n=75; 42.4 vs. 21.3%; P=0.03). The median OS and PFS times were significantly longer in the RT‑BoM group (24.9 vs. 16.3 months, P=0.01; 11.0 months vs. 6.2 months, P=0.03), while the incidence of irAEs was comparable (21.2 vs. 21.3%; P=0.99). The group that received RT before ICI initiation (n=22) had a significantly higher lung lesion response rate than the group that received RT after ICI initiation (n=11; 54.5 vs. 9.1%; P=0.02), with a trend toward prolonged OS and PFS. Multivariate analysis identified RT for BoMs as an independent predictor of lung response (P=0.02), OS (P=0.03) and PFS (P=0.02). RT for BoMs was associated with improved lung response and prognosis in patients with NSCLC receiving ICIs, suggesting a possible abscopal effect. Further validation in prospective studies with larger patient groups is warranted.
View Figures

Figure 1

(A) Overall survival and (B)
progression-free survival in the RT-BoM and non-RT-BoM groups. BoM,
bone metastasis; mOS, median overall survival; mPFS, median
progression-free survival; RT, radiotherapy.
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Copy and paste a formatted citation
Spandidos Publications style
Asano Y, Hayashi K, Miwa S, Taniguchi Y, Okuda M, Matsumoto I, Yano S and Demura S: Combination of immune checkpoint inhibitors and radiotherapy for bone metastases induces an abscopal effect and improves outcomes in non‑small cell lung cancer. Oncol Lett 30: 524, 2025.
APA
Asano, Y., Hayashi, K., Miwa, S., Taniguchi, Y., Okuda, M., Matsumoto, I. ... Demura, S. (2025). Combination of immune checkpoint inhibitors and radiotherapy for bone metastases induces an abscopal effect and improves outcomes in non‑small cell lung cancer. Oncology Letters, 30, 524. https://doi.org/10.3892/ol.2025.15270
MLA
Asano, Y., Hayashi, K., Miwa, S., Taniguchi, Y., Okuda, M., Matsumoto, I., Yano, S., Demura, S."Combination of immune checkpoint inhibitors and radiotherapy for bone metastases induces an abscopal effect and improves outcomes in non‑small cell lung cancer". Oncology Letters 30.5 (2025): 524.
Chicago
Asano, Y., Hayashi, K., Miwa, S., Taniguchi, Y., Okuda, M., Matsumoto, I., Yano, S., Demura, S."Combination of immune checkpoint inhibitors and radiotherapy for bone metastases induces an abscopal effect and improves outcomes in non‑small cell lung cancer". Oncology Letters 30, no. 5 (2025): 524. https://doi.org/10.3892/ol.2025.15270
Copy and paste a formatted citation
x
Spandidos Publications style
Asano Y, Hayashi K, Miwa S, Taniguchi Y, Okuda M, Matsumoto I, Yano S and Demura S: Combination of immune checkpoint inhibitors and radiotherapy for bone metastases induces an abscopal effect and improves outcomes in non‑small cell lung cancer. Oncol Lett 30: 524, 2025.
APA
Asano, Y., Hayashi, K., Miwa, S., Taniguchi, Y., Okuda, M., Matsumoto, I. ... Demura, S. (2025). Combination of immune checkpoint inhibitors and radiotherapy for bone metastases induces an abscopal effect and improves outcomes in non‑small cell lung cancer. Oncology Letters, 30, 524. https://doi.org/10.3892/ol.2025.15270
MLA
Asano, Y., Hayashi, K., Miwa, S., Taniguchi, Y., Okuda, M., Matsumoto, I., Yano, S., Demura, S."Combination of immune checkpoint inhibitors and radiotherapy for bone metastases induces an abscopal effect and improves outcomes in non‑small cell lung cancer". Oncology Letters 30.5 (2025): 524.
Chicago
Asano, Y., Hayashi, K., Miwa, S., Taniguchi, Y., Okuda, M., Matsumoto, I., Yano, S., Demura, S."Combination of immune checkpoint inhibitors and radiotherapy for bone metastases induces an abscopal effect and improves outcomes in non‑small cell lung cancer". Oncology Letters 30, no. 5 (2025): 524. https://doi.org/10.3892/ol.2025.15270
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