Long-termComplete Remission Following Radiosurgery and Immunotherapy in aMelanomaPatientwithBrainMetastasis : Immunologic Correlates

A melanoma patient with brain metastases was treated by gamma-knife radiosurgery and immunotherapy with autologous tumor-lysate–loaded dendritic cells (DC). Ten years after the combined treatment, the patient remains in complete remission. Remarkable immunologic correlates to the clinical development were the transient induction of NY-ESO-1 antibody and the durable expansion of MAGE-A1p161–169 EADPTGHSY–specific CD8þ T cells. Although the induction of NY-ESO-1 antibody most likely resulted from gamma-knife–mediated "auto-vaccination," the persistence of circulating MAGE-A1–specific T cells, which are still detectable ex vivo in the absence of any tumormanifestation, coincides with DC-based vaccination administeredmonthly until today. Cancer Immunol Res; 2(5); 404–9. 2014 AACR.

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