Table 3.

Merits and demerits of employing subcutaneous tumor autografts to prime a more efficacious abscopal effect.

Merits

Demerits

Most preclinical studies demonstrating effective abscopal responses have employed subcutaneous models The skin layers are known to be highly populated with professional antigen-presenting cells, which play an important role in effectively inducing abscopal responses. There may be better control of the priming process when using subcutaneous tumors, since priming could be done at optimal tumor sizes or time points, etc. Radiotherapy treatment planning for priming the subcutaneous tumors should be easier if location is chosen distant from sensitive organs at risk. There is an opportunity to use smart biomaterial skin implants for sustained delivery of immunoadjuvants toward more effective treatment outcomes as seen in vaccine studies Benefits of this approach may outweigh the risks for certain groups of patients

Subcutaneous tumors are expedient but provide limited recapitulation of the tumor microenvironment There is a need to first give patients an additional lesion before treating them Patients may reject autografts or homografts