帕博利珠单抗对移植肾肾盂转移性尿路上皮癌的完全缓解。
Complete response to pembrolizumab for metastatic urothelial carcinoma in the renal pelvis of allograft kidney.
作者信息
Kamei Jun, Yokoyama Hirotaka, Niki Toshiro, Suda Ryosuke, Sugihara Toru, Fujisaki Akira, Ando Satoshi, Iwami Daiki, Fujimura Tetsuya
机构信息
Department of Urology Jichi Medical University Tochigi Japan.
Department of Integrative Pathology Jichi Medical University Tochigi Japan.
出版信息
IJU Case Rep. 2022 Mar 25;5(3):199-202. doi: 10.1002/iju5.12438. eCollection 2022 May.
INTRODUCTION
We present a case of urothelial carcinoma in a renal allograft successfully treated with pembrolizumab.
CASE PRESENTATION
A 39-year-old woman presented with nausea and anorexia 9 years after a renal transplantation. Positron emission tomography revealed a neoplasm of the renal pelvis of the allograft and multiple lymph nodes with peritoneal metastasis. A diagnosis of a non-muscle-invasive bladder tumor with peritoneal dissemination and jejunal metastasis of urothelial carcinoma was made. After five cycles of gemcitabine and carboplatin, the tumor progressed and pembrolizumab was administered. One week after the first dose, the allograft was rejected, necessitating arterial embolization. After the second cycle, the patient developed Stevens-Johnson syndrome. After discontinuing pembrolizumab, positron emission tomography revealed no increased tumor activity. A complete response was achieved for 21 months without additional treatment.
CONCLUSION
Pembrolizumab was effective in treating urothelial carcinoma of the renal allograft; however, allograft rejection and loss should be considered.
引言
我们报告一例成功接受帕博利珠单抗治疗的肾移植受者发生尿路上皮癌的病例。
病例介绍
一名39岁女性在肾移植9年后出现恶心和厌食。正电子发射断层扫描显示移植肾肾盂有肿瘤，并有多个伴有腹膜转移的淋巴结。诊断为尿路上皮癌非肌层浸润性膀胱肿瘤伴腹膜播散和空肠转移。在接受五个周期的吉西他滨和卡铂治疗后，肿瘤进展，随后给予帕博利珠单抗治疗。首次给药一周后，移植肾发生排斥反应，需要进行动脉栓塞。在第二个周期后，患者出现史蒂文斯-约翰逊综合征。停用帕博利珠单抗后，正电子发射断层扫描显示肿瘤活性未增加。在未进行额外治疗的情况下，完全缓解持续了21个月。
结论
帕博利珠单抗对治疗肾移植受者的尿路上皮癌有效；然而，应考虑移植肾排斥和丢失的情况。
Zotero 插件