Fig. 1.

Representative case exhibiting the potential abscopal effect by concurrent palliative radiation with pembrolizumab treatment in metastatic urothelial carcinoma patients. Supraclavicular (yellow arrow) and paraaortic (blue arrow) lymph nodes progressed after second-line pembrolizumab, followed by the palliative radiation to the supraclavicular lymph node (2 Gy × 25fractions) by external beam radiation therapy (EBRT) with continuing pembrolizumab beyond disease progression. Computed tomography-two months later the radiation exhibited tumor shrinkage at not only supraclavicular but also un-irradiated paraaortic lymph nodes. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)