Long lasting complete response with immunotherapy in a metastatic bladder carcinoma: a case report

Abstract

At diagnosis, approximately 25% of urothelial carcinoma are invasive and only 15% of stage IV are alive at 5-years. We report a case of a 69-year-old woman with oligometastatic bladder cancer, treated with Atezolizumab in first-line, achieving a complete response after 4 cycles. Presently, the patient has an overall survival and progression free survival of 26 months with an improvement in her quality of life. Therefore, immunotherapy seems to be a promising treatment in advanced urothelial carcinoma. The previously performed radiotherapy, in association with a good performance status and oligometastatic disease, might have contributed to this admirable outcome.

Is there a role for metastasis-directed therapy in bladder cancer?

“…Table 1 provides an overview of the studies meeting our inclusion criteria, encompassing eight studies investigating MDT in BCa patients. These studies comprise three case reports [11][12][13], and five retrospective observational studies [14 & ,15,16,17…”

“…Table 1 provides an overview of the studies meeting our inclusion criteria, encompassing eight studies investigating MDT in BCa patients. These studies comprise three case reports [11–13], and five retrospective observational studies [14 ▪ ,15,16,17 ▪▪ ,18 ▪ ], all published within the last 2 years. Table 2 summarizes the oncological outcomes of MDT across the retrospective studies.…”

“…Data from [11–13,14 ▪ ,15,16,17 ▪▪ ,18 ▪ ,38–42]. AE, adverse events; BC, bladder cancer; DLTs, dose limiting toxicities; DOR, duration of response; DSS, disease-specific survival; HNCs, head and neck cancers; LC, local control; MDT, metastasis-directed therapy; MIBC, muscle invasive bladder cancer; mUBC, metastatic urothelial carcinoma of the bladder; NPD, nonprogression duration; NSCLC, nonsmall cell lung cancer; OMD, oligometastatic disease; ORR, objective response rate; OS, overall survival; pCR, pathologic complete response rate; PFS, progression free survival; QOL, quality of life; RCC, renal cell carcinoma; SBRT, stereotactic body radiation therapy; SOC, standard of care; TTP, time to progression; TURBT, transurethral resection of bladder tumor.…”

Defining Tumor Microenvironment as a Possible Target for Effective GEP-NENs Immunotherapy—A Systematic Review

“…Novel treatment options including immunotherapy have been presented for advanced tumors. Furthermore, treatment with immune checkpoint inhibitors can provide significantly improved response rates or even long-lasting complete responses in some cases [118][119][120]. Even though the success of immunotherapy has been proven in multiple clinical trials, to this day, a consensus regarding the optimal scope of patients for this therapy has not been reached [121][122][123][124].…”

A rare and complete response to combination therapy with radiation and nivolumab in a patient with metastatic urothelial cancer

“…Deep and long-lasting responses to immunotherapy scheduled soon after or simultaneously with radiotherapy have been reported in patients with advanced UC. Magalhães and colleagues reported in 2021 a case of unresectable oligometastatic UC that was treated with radiotherapy with a total dose of 56 Gy to pelvic lesion leading to lesion stabilisation at size 50×31 mm 15. Due to renal impairment, the patient was considered ineligible for chemotherapy and thus atezolizumab was initiated as the first-line therapy in April 2018.…”