Extended Data Fig. 9. Possible abscopal response in a patient with SCLC associated with an increase in monocytes/macrophages, as well as CD8+ T cells.
a. Timeline showing treatment and responses of mediastinal lymph nodes to treatment. The patient was a 59-year old female diagnosed with SCLC. She was initially treated with chemotherapy followed by olaparib and durvalumab (NCT02484404) and topotecan and berzosertib (NCT02487095). To relieve the symptoms caused by mediastinal lymph nodes, the patient was treated with radiotherapy (3000 cGy/10 fractions) and then treated with M7824 (for 7 months), a bifunctional fusion protein targeting PD-L1 and TGF-beta signaling. This patient died 12 months after radiotherapy due to aspiration pneumonia. b. CT images of pre- and 3 months post- radiotherapy and CT simulation image for radiotherapy planning. Although M7824 targets not only PD-1/PD-L1 but also TGF-beta signaling and is reported potent antitumor effects in some cancer types, M7824 did not show improved antitumor efficacy compared with historical results of immune checkpoint inhibitors in SCLC (NCT03554473). c. Absolute abundance of B cells, CD8+ T cells, CD4+ T cells, NK cells, monocytes/macrophages, and neutrophils based on CIBERSORT enumeration in cervical lymph node metastasis of pre- and post-radiotherapy. d. Representative flow cytometry analysis of J774A.1 mouse macrophage cells in culture 24 hours after adding FITC-ferumoxytol (Fe) to the culture medium at different concentrations. Experiment shown as a positive control of FITC-ferumoxytol phagocytosis by macrophages.