Open AccessPossible abscopal effect in urothelial carcinoma of the upper urinary tract after treatment with immune checkpoint inhibitors
Author(s) -
Ishiyama Yudai,
Takagi Toshio,
Yoshida Kazuhiko,
Iizuka Junpei,
Kakuta Yoichi,
Okumi Masayoshi,
Ishida Hideki,
Tanabe Kazunari
Publication year - 2020
Publication title -
iju case reports
Language(s) - English
Resource type - Journals
ISSN - 2577-171X
DOI - 10.1002/iju5.12133
Subject(s) - medicine , abscopal effect , radiation therapy , gemcitabine , lymph node , oncology , docetaxel , urology , pembrolizumab , chemotherapy , radiology , cancer , immunotherapy
Regression of non‐irradiated metastatic lesions after radiation therapy is known as the abscopal effect. We report a case of urothelial carcinoma in which the abscopal effect was possibly observed after immune checkpoint inhibitor administration. Case presentation A 68‐year‐old woman diagnosed with left renal pelvic cancer underwent total nephroureterectomy and regional lymph node dissection. Eight months later, imaging studies detected local recurrence and paraaortic lymph node metastasis. The tumor progressed despite cisplatin + gemcitabine, pembrolizumab, and gemcitabine + docetaxel therapy. Radiation therapy was administered to a painful back lesion, which resulted in dramatic symptom relief. Computed tomography 2 months after radiation therapy indicated reduced size of the irradiated lesion and some non‐irradiated lymph nodes. Conclusion Combined radiation therapy and immune checkpoint inhibitors can provide additional benefits for certain cancers, possibly due to negative immunomodulatory response blockade. Thus, this combined therapy may be a new metastatic urothelial carcinoma treatment strategy.