Successful response to camrelizumab in metastatic bladder cancer: A case report

Abstract

BACKGROUND There has been no report to use camrelizumab with chemotherapy for advanced bladder cancer patients with positive programmed death-ligand 1 (PD-L1) expression and high tumor mutational burden (TMB). More effective predictors of bladder cancer immunotherapy have yet to be explored, and the combination of multiple factors may be more predictive than a single factor. CASE SUMMARY We report the case of a 74-year-old male patient with recurrent metastatic bladder cancer, which demonstrated positive PD-L1 expression and high TMB. The immune checkpoint inhibitor camrelizumab was administered to the patient in combination with gemcitabine and cisplatin. The patient achieved a partial response with a progression-free survival of 11 mo. CONCLUSION This is the first report to use camrelizumab with chemotherapy for advanced bladder cancer patients with positive PD-L1 expression and high TMB.

Case report: Bladder preserving after maximal transurethral resection of the bladder tumor combined with chemotherapy and immunotherapy in recurrent muscle-invasive bladder cancer patients: A report of two cases

“…Since its widespread use in the treatment of malignant tumors, immunotherapy is effective in improving the survival of some tumor patients. However, some patients defined as PD-L1 positive have limited or no benefit after receiving immunotherapy ( 11 ). Tislelizumab, a novel humanized IgG4 monoclonal antibody ( 12 ), was approved by the National Medical Products Administration on April 10, 2020, for the treatment of locally advanced or metastatic combined PD-L1 high expression UC that had failed platinum-based chemotherapy including tumor progression during neoadjuvant chemotherapy or within 12 months of adjuvant chemotherapy ( 13 ).…”

“…Recent studies have found that TMB might predict the therapeutic efficacy of pembrolizumab in MIBC patients when the pretreatment TMB was ≥15 mutations/Mb ( 11 , 16 , 17 ). Based on the favorable treatment response to tislelizumab in the case 1 patient, we hypothesize that recurrent MIBC patients with high PD-L1 expression combined with high TMB (≥15 mutations/Mb) could benefit from tislelizumab.…”