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
357P - Application of multi-modal approach to palliation in end of life head and neck cancer pain
Presenter: Srujana Joga
Session: Poster display session
Resources:
Abstract
358P - Evaluation of continuous low dose versus standard dose capecitabine monotherapy as second/third-line chemotherapy for metastatic malignancies
Presenter: Swaroop Revannasiddaiah
Session: Poster display session
Resources:
Abstract
359P - Factors associated with economic burden among cancer patients with minor children: A cross-sectional web-based survey of an online cancer community
Presenter: Midori Yuki
Session: Poster display session
Resources:
Abstract
360P - Factors influencing treatment decisions among breast cancer patients in the Philippine general hospital cancer institute: Medical oncology outpatient clinic
Presenter: Bobby De Guzman
Session: Poster display session
Resources:
Abstract
361P - The role of volunteers in quality palliative care delivery
Presenter: NABANITA MANDAL
Session: Poster display session
Resources:
Abstract
362P - Survey to assess the efficacy of continuity of care delivered through an out of hours telephonic consultation liaison
Presenter: Rahul D. Arora
Session: Poster display session
Resources:
Abstract
366P - Activity of larotrectinib in TRK fusion cancer patients with primary central nervous system tumours
Presenter: David Ziegler
Session: Poster display session
Resources:
Abstract
367P - Molecular characteristics and efficacy of crizotinib among different subsets of MET Amplification detected by next-generation sequencing in lung cancer
Presenter: Jing Li
Session: Poster display session
Resources:
Abstract
368P - Genomic analysis of malaysian breast cancers unravel molecular differences from Caucasian breast cancers
Presenter: Soo-Hwang Teo
Session: Poster display session
Resources:
Abstract
369P - Institutional-based prospective molecular profiling of advanced solid tumours in Hong Kong: A report of 253 cases
Presenter: Herbert Loong
Session: Poster display session
Resources:
Abstract