Dataset Information

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.

SUBMITTER: Xie C

PROVIDER: S-EPMC8727277 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

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

Xie Chen C Yuan Xia X Chen Shu-Hui SH Liu Zhi-Yong ZY Lu Di-La DL Xu Feng F Chen Zhi-Qiu ZQ Zhong Xiao-Ming XM

World journal of clinical cases 20220101 1

<h4>Background</h4>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.<h4>Case summary</h4>We report the case of a 74-year-old male patient with recurrent metastatic bladder cancer, whi ...[more]

PMID: 35071525

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Project description:BackgroundAlthough rechallenge with platinum-based chemotherapy is effective for most platinum-sensitive recurrent ovarian cancer (ROC) patients, there is still a subset of patients who have no responses to the standard care. Overcoming multidrug resistance (MDR) is a top priority in oncology clinics, but it remains intricate. It is difficult for clinicians to manage unretractable ROC when conventional therapy yields no results. The rational and effective use of immunotherapy will contribute to the clinical benefit of these patients, especially in patients without approved immunotherapy biomarkers. Here we present a case of successful secondary radical surgery for unretractable metastatic MDR ROC by immunotherapy based on her immune-infiltrating tumor microenvironment signatures.Case descriptionA 57-year-old woman, diagnosed with IC2 stage high-grade serous ovarian cancer in 2015, underwent immediate ultra-radical cytoreductive surgery followed by 6 cycles of platinum-containing adjuvant chemotherapy. After nearly 37 months of disease-free status, the woman complained of spontaneous pain from the right subcostal margin for 1 month and was diagnosed with ROC accompanied by multiple unretractable colorectal and hepatic metastases. Standard chemotherapies were ineffective and quickly resulted in disease progression and grade IV myelosuppression followed impaired gastrointestinal function. Notably, after standard chemotherapy, the patient was tested negative for all immune biomarkers, but multiple fluorescence immunohistochemistry indicated that her tumor tissue was significantly infiltrated with the cluster of differentiation 8 (CD8) T cells and natural killer (NK) cells, implying potential benefits of immunotherapy. Then changed to 3 cycles of intravenous pembrolizumab, the main pelvic tumor and hepatic metastases showed significant shrinkage and achieved partial response, but the disease progressed after 8.7 months. Subsequently, arterial perfusion with pembrolizumab was performed combined with the chemotherapy. A comfortingly partial response was achieved again that enabled the patient to successfully undergo a secondary radical surgery for colorectal and liver metastases. Since that time the patient's postoperative course has been favorable, and she remains disease-free at present for at least 17 months.ConclusionsImmune infiltration signatures of the tumor microenvironment could serve as an indication for immunotherapy in patients with unretractable platinum-sensitive ROC with MDR. In addition, the introduction of immunotherapy might bring some degree of chemotherapy resensitization.

Project description:BackgroundSevere radiation-induced hemorrhagic cystitis (RHC) may ultimately require radical cystectomy. High-quality clinical evidence exists regarding the impact of hyperbaric oxygen therapy (HBOT) on RHC. However, there is a lack of reported data addressing the applicability of HBOT in very elderly patients (over 90 years old) with severe bleeding necessitating multiple blood transfusions.Case presentationThe patient is a 95-year-old male who suffered from severe hematuria due to RHC after 33 sessions of radiotherapy for muscle-invasive bladder cancer (T2N0M0, stage: II). After a series of subsequent therapies that failed to control the hematuria, the patient received 196 HBOTs between 11 October 2022 and 23 October 2023. Following a progressively adjusted HBOT protocol, the patient's hematuria (urine red blood cell (RBC) count showed 210,859 RBC/μL at maximum) was effectively controlled, and his symptoms subsequently resolved after 69 HBOTs. After the 196th HBOT, pelvic MRI revealed a reduction in the size of the lesion on the left posterior wall of the bladder compared to prior assessments. This reduction was suggestive of diminished intravesical hematoma. As of 26 October 2023, it is noteworthy that the patient's hemoglobin level has restored to the pre-hematuria level (106 g/L) with no need for blood transfusions for 8 consecutive months. Moreover, there was no recurrence of hematuria during the follow-up period. To the best of our knowledge, this report represents the first documented case of hematuria resolution in a patient over 90 years old with severe RHC.ConclusionThis case represents the first documented instance of successful hematuria resolution in a patient over 90 years of age with severe RHC. The positive therapeutic outcome achieved with personal protocol (1.4-1.6 ATA) in this 95-year-old patient, expands hyperbaric oxygen pressure options for elderly patients. Moreover, it also records a comprehensive dataset, including the time of the patient's recurrence of hematuria and the subsequent trend of hematuria control, which contributes valuable evidence to the research on HBOT for the repair of bladder mucosal tissue.

Dataset Information

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

Background

Case summary

Conclusion

Publications

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

Similar Datasets

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