Abstract YO15
Case summary
Concurrent Atezolizumab-Radiotherapy in Locally Recurrent Urinary Bladder Carcinoma: A Case Report
Abstract
Locally recurrent urinary bladder carcinoma is difficult to manage and cytotoxic chemotherapy regimens offer low response rates with high toxicities. Immune checkpoint inhibitors represent new opportunity for effective management of these patients. Atezolizumab produced durable responses, improved survival and tolerability in cisplatin-ineligible patients with locally advanced or metastatic urothelial carcinoma. High-dose radiation, in addition to its direct cell killing, could influence immune response. Combination of immune checkpoint inhibitor and radiation therapy have the potential to provide a synergistic effect in treating GU malignancies. This is a case of locally recurrent urinary bladder carcinoma responding to Atezolizumab plus radiotherapy.
A 66 year old male had 2 months history gross hematuria. Pelvic MRI showed a left-sided 3.4 x 2.4 x 2.8 cm urinary bladder tumor. A transurethral resection of bladder tumor (TURBT) was done and histopathology revealed high-grade urothelial carcinoma with glandular metaplasia and invasion of the lamina propria. The patient had a prolonged hospitalization due to subsequent emergency exploratory laparotomy secondary to ruptured peptic ulcer disease complicated by wound dehiscence and hospital-acquired pneumonia. 5 months from TURBT, re-evaluation KUB ultrasound showed mucosal irregularity (1.6 x 1.6 x 1.3 cm) in left side of Urinary bladder with a hypoechoic mass adjacent to it. Patient refused further work-up. At this time, he was also being treated for recurrent parapneumonic effusion. Radical cystectomy was contemplated but due to the patient’s condition the patient was deemed inoperable. Moreover, the patient refused cytotoxic chemotherapy. He thus underwent IMRT to 60 cGy concurrent with Atezolizumab 1200 mg IV every 21 days for 12 cycles. CT evaluation showed no residual or recurrent tumor. The patient remains to be asymptomatic with weight gain and on close surveillance.
Clinical trial identification
Editorial acknowledgement
Resources from the same session
339TiP - PACIFIC-5: Phase III study of durvalumab after either concurrent or sequential chemoradiotherapy (CRT) in patients with stage III NSCLC
Presenter: Yi-Long Wu
Session: Poster display session
Resources:
Abstract
340TiP - A multicenter, randomized, controlled, phase II trial exploring adjuvant combined therapy of apatinib and SHR-1210 (anti-PD-1), in patients with hepatocellular carcinoma at high risk of recurrence after radical resection
Presenter: Shida Yan
Session: Poster display session
Resources:
Abstract
347P - Relationship between modified surgical margin and prognosis of cutaneous squamous cell carcinoma
Presenter: Yukiko Teramoto
Session: Poster display session
Resources:
Abstract
348P - Malignant melanoma: A study of clinical profiles and treatment outcomes in Indian patients
Presenter: Sorun Shishak
Session: Poster display session
Resources:
Abstract
349P - Flavonoids from ethanol extracts of euphorbia hirta inhibit melanoma growth and metastatic potential
Presenter: Shubhra Mishra
Session: Poster display session
Resources:
Abstract
350P - Low-dose cisplatin and 5-fluorouracil combined concurrent chemoradiotherapy for unresectable cutaneous squamous cell carcinoma: Analysis of 23 cases
Presenter: Azusa Hiura
Session: Poster display session
Resources:
Abstract
353P - A prediction model for the intents regarding life-sustaining treatment decisions in patients with terminal cancer
Presenter: Yoonsun Kim
Session: Poster display session
Resources:
Abstract
354P - Predictive factors and survival outcomes with stereotactic body radiation therapy in treatment of oligometastases in colorectal cancer
Presenter: Vibhay Pareek
Session: Poster display session
Resources:
Abstract
355P - Cost analysis and overview of single versus multiple fraction palliative radiotherapy for painful bone metastasis
Presenter: Vinodhkumar Selvaraj
Session: Poster display session
Resources:
Abstract
356P - Observational study on role of crude cannabis in pain control and quality of life in terminally ill cancer patients: An Indian perspective
Presenter: Vidyasagar Dusi
Session: Poster display session
Resources:
Abstract