Dataset Information

Tumor regression after combination of radiation and PD-1 antibody nivolumab treatment in a patient with metastatic mediastinal leiomyosarcoma: a case report.

ABSTRACT: The PD-1/PD-L1 axis is characterized as an important checkpoint of immune activation, particularly through negatively regulating T cell function. Although accumulated evidence has demonstrated the patients with some types of tumor benefit from blockade of PD-1/PD-L1 signaling pathway, the possible synergistic effect of combination of radiotherapy and anti-PD-1/PD-L1 antibody still need to be explored. Here, we report a case of patient who was diagnosed with metastatic mediastinal leiomyosarcoma and treated by combination of local radiotherapy and anti-PD-1 antibody nivolumab. Remarkable tumor regression was observed at both the irradiated focus and distant metastatic sites 2 months later after combined treatment. The patient has tumor mutational burden (8.7 somatic mutations/Mb) and positive PD-L1 expression. The increased circulating lymphocytes suggest induced activation of immune response after combination treatment. Free disease progression has reached one and a half years as far.

SUBMITTER: Xi C

PROVIDER: S-EPMC6422505 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Tumor regression after combination of radiation and PD-1 antibody nivolumab treatment in a patient with metastatic mediastinal leiomyosarcoma: a case report.

Xi Chen C Wencheng Zhang Z Dong Qian Q Yong Guan G Cihui Yan Y Yuwen Wang W Hualei Zhang Z Puchun Er E Qingsong Pang P Ping Wang W

Cancer biology & therapy 20181102 4

The PD-1/PD-L1 axis is characterized as an important checkpoint of immune activation, particularly through negatively regulating T cell function. Although accumulated evidence has demonstrated the patients with some types of tumor benefit from blockade of PD-1/PD-L1 signaling pathway, the possible synergistic effect of combination of radiotherapy and anti-PD-1/PD-L1 antibody still need to be explored. Here, we report a case of patient who was diagnosed with metastatic mediastinal leiomyosarcoma ...[more]

PMID: 30388926

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Project description:BackgroundMetastatic neuroendocrine carcinoma has an extremely poor prognosis, and no effective second-line treatment is available. Herein, we describe a case of multiple metastases after primary resection of esophageal neuroendocrine carcinoma successfully treated with nivolumab plus radiotherapy in a short time.Case presentationA man in his 70s presented to our hospital after an abnormality was detected on an upper gastrointestinal series. Upper gastrointestinal endoscopy revealed a type 2 tumor spanning the endothelial cell junction to the abdominal esophagus. Histopathological examination of the biopsy confirmed a diagnosis of esophageal neuroendocrine carcinoma. The patient had no distant metastases. Thoracoscopic esophagectomy with three-field lymph node dissection was performed. Histopathological examination confirmed a diagnosis of esophageal neuroendocrine carcinoma with features of adenoid cystic-like carcinoma and squamoid pattern (pT2 [MP], INF a, ly1, v1 [EVG], pIM0, pDM0, pRM0, pN1 [1/28], M0; Stage II), which was positive for synaptophysin. The postoperative course was good, with no complications. The patient was treated with 100 mg of irinotecan and 100 mg of cisplatin, administered every 4 weeks, as postoperative adjuvant chemotherapy. Grade 3 loss of appetite was observed, and adjuvant chemotherapy was discontinued after four cycles of first-line treatment. A positron emission tomography-computed tomography scan 3 years after surgery showed abnormal uptake in the subaortic, left hilar, and left axillary lymph nodes, and in a mass in the right lung apex. The patient was diagnosed with metastatic esophageal neuroendocrine carcinoma postoperatively. First-line treatment could not be repeated due to toxicity from the initial treatment. Nivolumab (240 mg every 2 weeks) was administered as second-line treatment, and radiotherapy was started (56 Gy delivered in 28 fractions to the local [subaortic and hilar] lymph nodes). After 10 cycles of nivolumab in combination with radiotherapy (56 Gy), a positron emission tomography-computed tomography scan showed disappearance of all lesions. A complete response was achieved. Maintenance therapy (240 mg of nivolumab) was continued. No recurrence has been observed for 42 months.ConclusionsWe experienced a case in which nivolumab in combination with radiotherapy was effective for metastatic esophageal neuroendocrine carcinoma after primary resection.

Dataset Information

Tumor regression after combination of radiation and PD-1 antibody nivolumab treatment in a patient with metastatic mediastinal leiomyosarcoma: a case report.

Publications

Tumor regression after combination of radiation and PD-1 antibody nivolumab treatment in a patient with metastatic mediastinal leiomyosarcoma: a case report.

Similar Datasets

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