A case of complete response following the administration of pembrolizumab and metastasectomy for lung and bone metastases of bladder cancer

IJU Case Reports

article

Takehiko Nakasato¹  Tatsuki Inoue¹  Ryosuke Kato¹  Yoshihiro Nakagami¹  Kazuhiko Oshinomi¹  Yoshiko Maeda¹  Jun Morita¹  Takeshi Shichijo¹  Toshiko Yamochi³  Takashi Fukagai¹ 

[1] Departments of, Urology, Showa University School of Medicine;Contribution: Project administration;Pathology, Showa University School of Medicine;Contribution: Supervision

关键词: bladder cancer;    complete response;    metastasectomy;    pembrolizumab;    urothelial cancer;   

DOI  :  10.1002/iju5.12402

学科分类：社会科学、人文和艺术（综合）

来源: Wiley

【 摘 要 】

Introduction Patients with metastatic urothelial carcinoma have poor prognosis and limited treatment options. Case presentation The patient was a 60-year-old male with bladder cancer and multiple lung metastases. He underwent three courses of gemcitabine and cisplatin chemotherapy, despite left femoral bone metastases. Tumor resection and bone replacement surgery was performed. Following the administration of four courses of pembrolizumab, lung metastasis completely resolved. However, after nine courses, right femoral neck bone metastasis was observed; therefore, tumor resection and bone replacement surgery were repeated. Pathologically, PD-L1 expression was low in lung biopsy tissue and bone metastases. Pembrolizumab treatment continued for up to 20 courses; cancer recurrence and adverse events were not observed upon follow-up examination after 1 year. Conclusion Patients responding well to systemic therapy may have resectable metastatic sites, and long-term survival might be achieved with adjunctive metastasectomy. The effect of pembrolizumab was not associated with positive PD-L1 expression.

【 授权许可】

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