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
YO20 - Can "Superman" have Chronic Myelomonocytic Leukemia?
Presenter: Alexander Luchinin
Session: Poster display session
Resources:
Abstract
YO21 - Sanctuary Site Central Nervous System Relapse-Refractory DLBCL Responding to Nivolumab and Lenalidomide.
Presenter: Irappa Madabhavi
Session: Poster display session
Resources:
Abstract
YO22 - External Auditory Canal Mass: A Case Series of Squamous Cell Carcinoma
Presenter: Mel Valerie Cruz-Ordinario
Session: Poster display session
Resources:
Abstract
YO23 - Soft tissue Giant cell tumor presented as Nasopharyngeal mass: A case report
Presenter: Emmelyn Buenacosa-Nepucpan
Session: Poster display session
Resources:
Abstract
YO25 - Hyperprogression after pembrolizumab in recurrent oropharyngeal cancer and the use of nab-paclitaxel as salvage treatment- A case report.
Presenter: Izzati Rosli
Session: Poster display session
Resources:
Abstract
YO26 - Exacerbation of radiation necrosis around the radiotherapy-pretreated brain metastases site after immune checkpoint inhibitors.
Presenter: Minako Nishio
Session: Poster display session
Resources:
Abstract
YO27 - Comparative Study Of 20Gray/5Fraction And 30Gray/10 Fraction Whole Brain Radiation In Brain Metastasis
Presenter: Pradip Bhandari
Session: Poster display session
Resources:
Abstract
YO28P - The response to anaplastic lymphoma kinase (ALK) inhibitor in metastatic anaplastic thyroid carcinoma (ATC)
Presenter: Nur Faizah Ab Muin
Session: Poster display session
Resources:
Abstract
YO29 - Acute kidney injury secondary to bilateral renal artery tumor thrombosis in a case of posterior mediastinal undifferentiated sarcoma: case report
Presenter: Ritsu Ibusuki
Session: Poster display session
Resources:
Abstract
YO30 - Follicular dendritic cell sarcoma of the tonsil- a multimodality approach
Presenter: Rich Ericson King
Session: Poster display session
Resources:
Abstract