A PD-1 Inhibitor Induces Complete Response of Advanced Bladder Urothelial Carcinoma: A Case Report

Wang, Jianzheng; Li, Qingli; Lv, Haiyan; Nie, Caiyun; Chen, Beibei; Xu, Weifeng; Yang, Tiejun; Zhang, Yinping; Tu, Shuiping; Chen, Xiaobing

doi:10.3389/fonc.2021.671416

Cited by 7 publications

(5 citation statements)

References 28 publications

(26 reference statements)

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“… 22 Finally, a patient with metastatic bladder cancer achieved CR sustained over 1 year, after four administrations of sintilimab. 23 No comparable response regarding reports of cases with HNSCC were identified. In addition, the case presented here remains unique due to the long duration of sustained CR.…”

Section: Discussionmentioning

confidence: 99%

Serendipitous synergism – an exceptional response to treatment with pembrolizumab in the course of a natural immunovirotherapy: a case report and review of the literature

Khoury

Burcher

et al. 2022

Ther Adv Med Oncol

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Immune checkpoint inhibitors (ICIs) are the current guideline recommended treatment for many malignancies considered to be terminal. Despite considerable advances, their utility remains limited, and the field requires synergistic partners to further improve outcomes. Oncolytic viruses (OV) are emerging as contenders for the role of the synergistic agent of choice due to their multi-mechanistic effect on activating the tumor ‘cold’ immune microenvironment. Herpes simplex virus 1, a naturally selective OV, is the most advanced virotherapeutic compound in clinical applications for use in combination with ICI. We here present the case of a 72 year-old patient with a heavily pre-treated, advanced maxillary sinus squamous cell cancer with distant metastases who developed complete response (CR) with only three administrations of a programmed death 1 inhibitor after treatment interference by a severe herpes zoster infection, based on the related alpha-herpesvirus varicella zoster virus (VZV). This exceptional response has been followed and confirmed with imaging studies over more than 5 years. Although the patient had several favorable predictors for response to immunotherapy, we reason that the exceptional response may in part be secondary to the serendipitous VZV infection. Documented cases of cancer patients that achieved CR after few administrations of treatment with ICI are rare, with most reporting follow up of just over 1 year or less. In this case, it is conceivable that the interference of the infection with VZV, soon after the start of immunotherapy with ICI, led to a lasting antitumor immunity and sustained CR. This hypothesis is supported by the concept of ‘oncolytic immunotherapy’ which is reviewed in this manuscript. In addition, persistence of a TP53 mutation found in a liquid biopsy, despite clinical and radiologic remission, is discussed.

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Section: Discussionmentioning

confidence: 99%

Serendipitous synergism – an exceptional response to treatment with pembrolizumab in the course of a natural immunovirotherapy: a case report and review of the literature

Khoury

Burcher

et al. 2022

Ther Adv Med Oncol

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“…observed that following treatment with gemcitabine, a patient who had advanced urothelial carcinoma exhibited disease progression. The patient experienced long-term complete remission after receiving only a domestic PD-1 inhibitor (sintilimab) ( 12 ). Fukuta et al.…”

Section: Discussionmentioning

confidence: 99%

Isolated Renal Calyceal Urothelial Carcinoma Effectively Treated With PD-1 Inhibitor Alone: A Case Report And Literature Review

Zhu

et al. 2022

Front. Oncol.

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The discovery of immune checkpoint inhibitors (ICIs) represents a significant step forward in the battle against malignant tumors. In a number of advanced malignancies, ICIs, such as antibodies to programmed cell death protein-1 inhibitor (PD-1) and its ligand, programmed death-ligand 1 (PD-L1), have shown good therapeutic benefits. A 71-year-old male patient was diagnosed with solitary renal calyceal urothelial cancer. The space-occupying lesion in the upper calyx of the left kidney dramatically decreased after 13 treatments with a PD-1 inhibitor (tislelizumab) alone, and the tumor reached partial remission. This case suggests that a PD-1 inhibitor (tislelizumab) alone may be an effective treatment strategy for solitary renal calyceal urothelial carcinoma.

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“…Although surgical resection in combination with chemotherapy is recognized as the optimal treatment for this lethal malignancy, the long-term survival remains unsatisfactory owing to the late detection, early recurrence, and aggressive biological manner of the tumor ( 8 ). In recent years, immunotherapy with immune checkpoint inhibitors (ICIs) has shown beneficial effects and good safety for various solid cancers including non-small cell lung cancer ( 9 ), gallbladder carcinosarcoma ( 10 ), bladder urothelial carcinoma ( 11 ), colorectal adenocarcinoma ( 12 ), etc. For gastric cancer, immunotherapy has also drastically improved the treatment options in the advanced phase, especially for chemorefractory gastric cancer ( 4 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Pathologic complete response of hepatoid adenocarcinoma of the stomach after chemo-immunotherapy: A rare case report and literature review

et al. 2023

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BackgroundHepatoid adenocarcinoma of the stomach (HAS) is a highly malignant subtype of gastric carcinoma with specific clinicopathological features and extremely poor prognosis. We present an exceedingly rare case of complete response after chemo-immunotherapy.Case DescriptionA 48-year-old woman with highly elevated serum alpha-fetoprotein (AFP) level was found to have HAS verified by pathological examination based on gastroscopy. Computed tomography scan was done and TNM staging of the tumor was T4aN3aMx. Programmed cell death ligand-1 (PD-L1) immunohistochemistry was performed, revealing a negative PD-L1 expression. Chemo-immunotherapy including oxaliplatin plus S-1 and PD-1 inhibitor terelizumab was given to this patient for 2 months until the serum AFP level decreased from 748.5 to 12.9 ng/mL and the tumor shrank. D2 radical gastrectomy was then performed and histopathology of the resected specimen revealed that the cancerous cells had disappeared. Pathologic complete response (pCR) was achieved and no evidence of recurrence has been found after 1 year of follow-up.ConclusionsWe, for the first time, reported an HAS patient with negative PD-L1 expression who achieved pCR from the combined chemotherapy and immunotherapy. Although no consensus has been reached regarding the therapy, it might provide a potential effective management strategy for HAS patient.

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A PD-1 Inhibitor Induces Complete Response of Advanced Bladder Urothelial Carcinoma: A Case Report

Cited by 7 publications

References 28 publications

Serendipitous synergism – an exceptional response to treatment with pembrolizumab in the course of a natural immunovirotherapy: a case report and review of the literature

Serendipitous synergism – an exceptional response to treatment with pembrolizumab in the course of a natural immunovirotherapy: a case report and review of the literature

Isolated Renal Calyceal Urothelial Carcinoma Effectively Treated With PD-1 Inhibitor Alone: A Case Report And Literature Review

Pathologic complete response of hepatoid adenocarcinoma of the stomach after chemo-immunotherapy: A rare case report and literature review

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