PMC5422722_01
Axial contrast-enhanced CT image on the left shows a huge left para-aortic mass (red arrow) with irregular hypodense areas of necrosis on March 30, 2016, following re-treatment with platinum doublets after RRx-001. Due to radiologic progression, the platinum doublets were stopped and nivolumab was started. On June 3, 2016, the patient was rescanned, which demonstrated that the para-aortic mass disappeared completely (red arrow).
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F1
At 6 weeks, having progressed according to RECIST v.1.1 despite the appearance of centrally hypodense tumor necrosis on CT (Fig. 1), the patient was rechallenged per protocol with cisplatin and etoposide on March 1, 2016. She started nivolumab 3 mg/kg every other week with initial evidence of a partial response (Fig. 1), attributed to the priming effect of RRx-001, since necrotic tumor cells may provide a source of tumor antigen, before passing away.