Camrelizumab monotherapy leading to partial remission for relapsed upper tract urothelial carcinoma after radical nephroureterectomy: a case report

Ni, Kangxin; Wang, Zhenghui; Yu, Shicheng; Zheng, Jintong; Li, Gonghui

doi:10.21037/tau-21-268

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…Moreover, in a single-arm phase 2 trial (NCT04004221/CTR20170071), tislelizumab (anti-PD-1 monoclonal antibody) as second-line therapy in PD-L1 positive (SP263) UC patients who progressed during/following platinum-containing therapy and had no prior PD-1/L1 inhibitor treatment achieved a confirmed objective response rate of 24% in 104 evaluable patients, including 10 complete and 15 partial responses. Median progression-free survival and overall survival were 2.1 and 9.8 mo, respectively[ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…For accurate analysis, we reviewed a series of previous studies, based on PD-L1 assays (SP263) and cut-off values (TPS ≥ 25%) that were used in clinical trials of tislelizumab, and applied them to our case[ 18 , 25 ]. Furthermore, to minimize manual error, automated quantification and interpretation of the PD-L1 IHC results were adopted in this case.…”

Section: Discussionmentioning

confidence: 99%

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Bladder preservation in complicated invasive urothelial carcinoma following treatment with cisplatin/gemcitabine plus tislelizumab: A case report

Yang¹,

Chen²,

Luo³

et al. 2023

World J Clin Cases

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BACKGROUND Invasive urothelial carcinoma (UC) with squamous and glandular differentiation is a highly malignant and complicated pathological subtype, and the standard care is radical cystectomy (RC). However, urinary diversion after RC significantly reduces patient quality of life, thus bladder-sparing therapy has become a research hotspot in this field. Recently, five immune checkpoint inhibitors have been approved for systemic therapy of locally advanced or metastatic bladder cancer by the Food and Drug Administration, but the efficacy of immunotherapy combined with chemotherapy for invasive UC is still unknown, especially for pathological subtypes with squamous and glandular differentiation. CASE SUMMARY We report the case of a 60-year-old male who complained of repetitive painless gross hematuria and was diagnosed with muscle-invasive bladder cancer with squamous and glandular differentiation, defined as cT3N1M0 according to the American Joint Committee on Cancer, who had a strong desire to preserve the bladder. Immunohistochemical staining revealed that programmed cell death-ligand 1 (PD-L1) expression in the tumor was positive. Thus, a transurethral resection to maximize removal of the bladder tumor was performed under cystoscopy, and the patient subsequently received a combination of chemotherapy (cisplatin/gemcitabine) and immunotherapy (tislelizumab) treatment. No tumor recurrence in the bladder was observed following pathological and imaging examination after 2 cycles and 4 cycles of treatment, respectively. The patient achieved bladder preservation and has been tumor-free for more than two years. CONCLUSION This case shows that the combination of chemotherapy and immunotherapy might be an effective and safe treatment strategy for PD-L1 expression positive UC with divergent histologic differentiation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bladder preservation in complicated invasive urothelial carcinoma following treatment with cisplatin/gemcitabine plus tislelizumab: A case report

Yang¹,

Chen²,

Luo³

et al. 2023

World J Clin Cases

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“…Since 2016, a total of five immune checkpoint inhibitors (ICIs) have been approved for metastatic UC (mUC) as first and second-line treatments [ 11 ]. As a PD-1 inhibitor, camrelizumab has received approval in China for treating relapsed or refractory classical Hodgkin lymphoma [ 12 ], and our research team reported a case of camrelizumab in the treatment for relapsed UTUC after RNU [ 13 ]. However, data extracted from subgroup analysis of UC have been controversial [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Immunotherapy with or without targeted therapy for metastatic upper tract urothelial carcinoma: case report and literature review

Wang

et al. 2023

Heliyon

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“…Tislelizumab and toripalimab have resulted in encouraging outcomes for advanced UC in clinical trials (Ye et al, 2021;Sheng et al, 2022), and they were approved by the National Medical Products Administration for advanced UC. Camrelizumab and sintilimab have also shown beneficial effects in some cases (Cao et al, 2021;Ni et al, 2021;Wang et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Adverse Events of PD-1 Inhibitors in Patients With Advanced Urothelial Carcinoma From a Real-World Experience

et al. 2022

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Background: Programmed death 1 (PD-1) inhibitors—tislelizumab, toripalimab, camrelizumab, and sintilimab—are used for advanced urothelial carcinoma (UC) in China. To date, the efficacy and adverse events (AEs) of these PD-1 inhibitors have been poorly reported for advanced UC.Methods: We reviewed 118 patients treated with PD-1 inhibitors for advanced UC from July 2019 to October 2021 at Yantai Yuhuangding Hospital. Patient data were obtained from hospital records and telephone follow-ups. The safety and efficacy of PD-1 inhibitors were assessed by RESIST and Common Terminology Criteria for Adverse Events (version 4.0), respectively.Results: During a median follow-up period of 6 months, 112 patients (95%) experienced AEs; of these, 104 (88%) were grade 1–2 AEs, and 60 (51%) were grade 3–4 AEs. The most common AE was anemia, and no patients died as a result of treatment. A subanalysis according to treatment method (PD-1 inhibitor vs. PD-1 inhibitor plus chemotherapy) was performed. The incidence of grade 1–2 AEs was not different between the groups (85% vs. 94%), but combination therapy significantly increased grade 3–4 AEs (32% vs. 89%). Monotherapy and combination therapy also did not differ with regard to immune-related AEs of grades 1–2 (13% vs. 22%) or grades 3–4 (1% vs. 6%). In efficacy, complete response was not observed, but 33 patients (28%) had partial response, 30 (25%) had stable disease, and 47 had progressive disease (40%). The overall response and disease control rates were 28% and 53%, respectively. The preliminary efficacy of disease control was better with combination therapy versus monotherapy (78 vs. 43%).Conclusion: PD-1 inhibitors show promising tolerance and efficacy in advanced UC. PD-1 inhibitors combined with chemotherapy offered better disease control but had more grade 3–4 AEs. The clinical use of combination therapy warrants caution.

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Camrelizumab monotherapy leading to partial remission for relapsed upper tract urothelial carcinoma after radical nephroureterectomy: a case report

Cited by 3 publications

References 21 publications

Bladder preservation in complicated invasive urothelial carcinoma following treatment with cisplatin/gemcitabine plus tislelizumab: A case report

Bladder preservation in complicated invasive urothelial carcinoma following treatment with cisplatin/gemcitabine plus tislelizumab: A case report

Immunotherapy with or without targeted therapy for metastatic upper tract urothelial carcinoma: case report and literature review

Efficacy and Adverse Events of PD-1 Inhibitors in Patients With Advanced Urothelial Carcinoma From a Real-World Experience

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