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Title: ペムブロリズマブ投与中に肝転移のPseudoprogressionを認めた転移性尿路上皮癌の1例
Other Titles: A Case of Metastatic Urothelial Carcinoma with Pseudoprogression of Liver Metastasis during the Treatment with Pembrolizumab
Authors: 増田, 寛雄  KAKEN_name
加藤, 実  KAKEN_name
吉内, 皓樹  KAKEN_name
行松, 直  KAKEN_name
平山, 幸良  KAKEN_name
大年, 太陽  KAKEN_name
山﨑, 健史  KAKEN_name
鞍作, 克之  KAKEN_name
内田, 潤次  KAKEN_name
Author's alias: MASUDA, Hiroo
KATO, Minoru
HIRAYAMA, Yukiyoshi
Keywords: Metastatic urothelial carcinoma
Issue Date: 30-Apr-2022
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 68
Issue: 4
Start page: 117
End page: 121
Abstract: A 75-year-old woman with a complaint of gross hematuria was referred to our hospital. The patient was diagnosed as having bladder cancer (cT3bN1M0) and received two cycles of chemotherapy with gemcitabine and cisplatin. Radical cystectomy with pelvic lymph node dissection and bilateral ureterostomy was performed after achieving partial response in a lymph node metastasis following chemotherapy. Based on the pathological diagnosis of high-grade (G3) urothelial carcinoma (ypT3aN2), two more cycles of adjuvant chemotherapy with gemcitabine and cisplatin were administered. Four months after completing adjuvant chemotherapy, pulmonary and hepatic metastases appeared, and treatment with pembrolizumab was initiated. The size of the lung metastasis decreased, while that of the liver metastasis increased 2 months after administering pembrolizumab. However, considering treatment beyond progression using checkpoint inhibitors, pembrolizumab was continued, resulting in marked tumor shrinkage of the liver metastasis. After that, pembrolizumab treatment was temporarily discontinued, and radiation therapy was administered for a new lymph node metastasis at the tracheal bifurcation. Eventually, the lymph node metastasis shrank, and the treatment with pembrolizumab was recommenced for 1 year and the metastases remained shrumken.
Rights: 許諾条件により本文は2023/05/01に公開
DOI: 10.14989/ActaUrolJap_68_4_117
PubMed ID: 35613900
Appears in Collections:Vol.68 No.4

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