scholarly journals Complete response to pembrolizumab in recurrent nested variant of urothelial carcinoma

2021 ◽  
Author(s):  
Kyotaro Fukuta ◽  
Hirofumi Izaki ◽  
Keito Shiozaki ◽  
Ryoichi Nakanishi ◽  
Tohru Inai ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Complete Response ◽  
Nested Variant

scholarly journals Pembrolizumab-Induced Severe Neuropathy in a Patient with Metastatic Urothelial Carcinoma after Achieving Complete Response: Guillain-Barré Syndrome-Like Onset

2020 ◽  
Vol 13 (3) ◽  
pp. 1490-1494
Author(s):  
Shuntaro Aoki ◽  
Masato Yasui ◽  
Hironao Tajirika ◽  
Hideyuki Terao ◽  
Makoto Funahashi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Urothelial Carcinoma ◽  
Lung Metastases ◽  
Complete Response ◽  
Guillain Barre Syndrome ◽  
Node Metastasis ◽  
Aortic Lymph Node ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

An 85-year-old female was admitted to our hospital for left ureteral cancer and para-aortic lymph node metastasis. To control hematuria, a laparoscopic retroperitoneal nephroureterectomy was performed, and papillary urothelial carcinoma (pT3b) was found. To treat para-aortic lymph node metastasis, she received chemotherapy with gemcitabine and nedaplatin. After 2 cycles, a computed tomography scan revealed its disappearance; however, bilateral lung metastases appeared. The patient was administered second-line therapy with pembrolizumab every 3 weeks. After 3 courses, lung metastases disappeared and she achieved a complete response. After the fifth administration of pembrolizumab, she was readmitted with right upper limb pain and weakness in both lower extremities. She was diagnosed with pembrolizumab-induced grade 3 peripheral neuropathy with Guillain-Barré syndrome-like onset. High-dose monocorticotherapy was initiated for treatment. Three weeks later, the pain and weakness of the limbs improved. After discharge, the dose of prednisolone was tapered and there was no relapse of adverse events. Pembrolizumab was discontinued at the onset of neuropathy, but she maintained a complete response.

scholarly journals Development of secondary urothelial carcinoma following complete response to immune checkpoint inhibitors

2021 ◽  
pp. 101762
Author(s):  
Jean-Michel Lavoie ◽  
Gillian Vandekerkhove ◽  
Andrew J. Murtha ◽  
Gang Wang ◽  
Alexander W. Wyatt ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Complete Response

scholarly journals Revisiting an Old Conundrum: A Systematic Review and Meta-Analysis of Intravesical Therapy for Treatment of Urothelial Carcinoma of the Prostate

2021 ◽  
pp. 1-10
Author(s):  
Andrea Kokorovic ◽  
Mary E. Westerman ◽  
Kate Krause ◽  
Mike Hernandez ◽  
Nathan Brooks ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Complete Response ◽  
Intravesical Therapy ◽  
Cochrane Library ◽  
Carcinoma Of The Prostate ◽  
Non Invasive ◽  
Bcg Therapy ◽  
Mucosal Involvement

BACKGROUND: The optimal management of non-invasive (mucosal and/or ductal) urothelial carcinoma of the prostate remains elusive and there is a paucity of data to guide treatment. OBJECTIVE: Our objective was to systematically review and synthesize treatment responses to conservative management of non-invasive prostatic urothelial carcinoma using intravesical therapy. METHODS: A systematic literature search using MEDLINE, EMBASE, Cochrane Library, SCOPUS, and Web of Science databases from inception to November 2019 was performed. Risk of bias assessment was performed using the Newcastle-Ottawa scale for non-randomised studies. Pooled estimates of complete response in the bladder and prostate and prostate only were performed using a random effects model. Pre-specified subgroup analyses were generated to assess differences in complete responses for: BCG therapy vs other agents, ductal vs mucosal involvement, CIS vs papillary tumors and TURP vs no TURP. RESULTS: Nine studies including 175 patients were identified for inclusion in the systematic review and meta-analysis. All were retrospective case series and most evaluated response to BCG therapy. The pooled global complete response rate for intravesical therapy was 60%(95%CI: 0.48, 0.72), and for prostate 88%(95%CI: 0.81, 0.96). Pre-specified analyses did not demonstrate statistically significant differences between subgroups of interest. CONCLUSIONS: Management of non-invasive prostatic urothelial carcinoma using intravesical therapy yields satisfactory results. Caution should be taken in treating patients with papillary tumors and ductal involvement, as data for these populations is limited. TURP may not improve efficacy, but is required for staging. Current recommendations are based on low quality evidence, and further research is warranted.

scholarly journals Nested variant of urothelial carcinoma of the urinary bladder

Rare Tumors ◽  
2011 ◽  
Vol 3 (4) ◽  
pp. 132-134 ◽  
Author(s):  
Tadashi Terada
Keyword(s):  
Urothelial Carcinoma ◽  
Lamina Propria ◽  
Bladder Tumor ◽  
Clinical Course ◽  
Carcinoma Cells ◽  
Ki 67 ◽  
Atypical Cells ◽  
Nested Variant ◽  
Aggressive Clinical Course ◽  
Nephrogenic Metaplasia

The nested variant of urothelial carcinoma (NVUC) is characterized by the presence of benign-appearing urothelial carcinoma cells in the lamina propria, sparing the surface urothelial involvement. NVUC shows aggressive clinical course despite of benign-looking histology. Herein reported are two cases of NVUC. One is 80-year-old woman, and another is 78-year-old man. In both cases, atypical cells forming nests and tubules were seen in the lamina propria without surface urothelial involvement. One case resembled nephrogenic metaplasia and another proliferated Brunn's nest or inverted papilloma. Immunohistochemically, both cases showed positive p53 and high Ki67 labeling, suggesting that both cases are malignant. Immunohistochemically, one case was characterized by positive cytokeratins, EMA, p53, Ki-67 (labeling=15%), α-methylacyl CoA racemase, CA19-9, and MUC1, and another case by positive cytokeratins, EMA, p63, p53, Ki-67 (lebeling=30%), CD10, CEA, and MUC1. Cyto keratin immunoprofiles were described and other antigens’ expressions were shown. The patients are now free of tumor 6 and 15 months after the resection of the bladder tumor.

Escalated dosages of methotrexate, vinblastine, doxorubicin, and cisplatin plus recombinant human granulocyte colony-stimulating factor in advanced urothelial carcinoma: an Eastern Cooperative Oncology Group trial.

1994 ◽  
Vol 12 (3) ◽  
pp. 483-488 ◽  
Author(s):  
P J Loehrer ◽  
P Elson ◽  
R Dreicer ◽  
R Hahn ◽  
C R Nichols ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Eastern Cooperative Oncology Group ◽  
Dose Intensity ◽  
Complete Response ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Duration Of Response ◽  
Advanced Urothelial Carcinoma ◽  
Grade 3 ◽  
Stimulating Factor

PURPOSE This multicenter cooperative group phase I/II trial evaluated the toxicity and efficacy of escalated dosages of methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) with recombinant human granulocyte colony-stimulating factor (rhG-CSF) in patients with advanced urothelial carcinoma. PATIENTS AND METHODS From November 1990 through October 1991, 35 patients with advanced urothelial cancer previously untreated with chemotherapy were treated with escalated dosages of M-VAC (M-VACII). In patients with prior pelvic radiotherapy, standard M-VAC (M-VACI) was administered plus rhG-CSF. For other patients, M-VACII dosages were methotrexate 40 mg/m2 (days 1, 15, and 22), vinblastine 4 mg/m2 (days 2, 15, and 22), doxorubicin 40 mg/m2 (day 2), and cisplatin 100 mg/m2 (day 2). In addition, rhG-CSF was administered at a dosage of 300 micrograms subcutaneously on days 4 to 11. Cycles were repeated every 4 weeks. For patients who tolerated the first course of therapy, subsequent escalation by 25% of all drugs was performed. RESULTS Six complete responses and 15 partial responses were observed (60%; 95% confidence interval, 42% to 76%). The median duration of response was 4.6 months, and the median survival time was 9.4 months (range, 0.5 to 23.5+). Twenty-eight of 35 patients experienced grade 3 or 4 leukopenia, including 14 patients who developed fever associated with neutropenia. Eight (23%) early deaths were observed. CONCLUSION This regimen (M-VACII) with escalated dosages of M-VAC was associated with significant toxicity and had no apparent benefit over M-VACI therapy with regard to complete response rate or survival. Further evaluation of the dose-intensity of the components of this regimen in this disease is likely to be of limited benefit to patients.

Nested Variant Urothelial Carcinoma of the Bladder

Urology ◽  
2020 ◽  
Vol 144 ◽  
pp. 9-12
Author(s):  
Tracy R. Shachner ◽  
Eric Riedinger ◽  
Alan D. Grindstaff ◽  
James Bienvenu ◽  
Wesley M. White
Keyword(s):  
Urothelial Carcinoma ◽  
Nested Variant ◽  
Carcinoma Of The Bladder

Pure form of a nested variant of urothelial carcinoma of the urinary bladder—A case report—

2015 ◽  
Vol 54 (6) ◽  
pp. 377-382
Author(s):  
Tomonori KOZAKAI ◽  
Keiji IIZUKA ◽  
Kazuyo NISHIZAWA ◽  
Akiko ISHIDA ◽  
Hiroyoshi OTA
Keyword(s):  
Case Report ◽  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Pure Form ◽  
Nested Variant

Sarcomatoid urothelial carcinoma (SUC): A single-institution experience of oncologic outcomes and recurrence patterns.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 465-465
Author(s):  
Leonidas Nikolaos Diamantopoulos ◽  
Rishi Robert Sekar ◽  
Ali Raza Khaki ◽  
Brian Winters ◽  
Funda Vakar-Lopez ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Complete Response ◽  
Oncologic Outcomes ◽  
Time To Recurrence ◽  
Treatment Data ◽  
Recurrence Patterns ◽  
Fluid Collections ◽  
Cystic Masses

465 Background: SUC is a rare histology with aggressive behavior. We evaluated outcomes and recurrence patterns of patients (pts) with SUC, in comparison with conventional urothelial carcinoma (CUC). Methods: We retrospectively assessed our radical cystectomy (RC) database to identify pts with cT2-4 SUC (any %) or CUC, at RC or transurethral resection specimens. Clinicopathologic/treatment data were captured and compared with t and χ2 tests, as appropriate. Overall survival (OS; diagnosis to death) and recurrence-free survival (RFS; RC to recurrence or death) were estimated (KM method). Significant factors in univariable (UVA) Cox regression for OS were included in multivariable analysis (MVA). Results: We identified 38 consecutive pts with cT2-4 SUC and 287 with CUC (2003-2018); 17 (45%) and 162 (56%) received neoadjuvant chemotherapy (NAC). The primary non-mesenchymal component was urothelial in all SUC cases. SUC had higher rates of pT3/4 (66% vs. 35%, p < .001) but comparable rates of pN+ disease (26% vs. 20%, p = .38). Complete response (ypT0N0) after NAC was lower for SUC (6% vs. 35%, p = .02). Median follow-up was 73.6 months (95%CI 62.6 – 84.7). Median RFS and OS was inferior among pts with SUC (9.4 vs 109.8 months, p < .001, 19.7 vs. 130.4 months, p < .001 respectively). On MVA, SUC was independently associated with worse OS ( Table). Of 17 (45%) pts with SUC who recurred post-RC, 5 presented with abdomino-pelvic cystic masses, with an average time to recurrence < 5 months. Conclusions: SUC was associated with high rates of extravesical spread at RC and worse NAC response, RFS and OS, vs. CUC. Development of abdomino-pelvic fluid collections should raise suspicion of recurrence among pts with this histology. [Table: see text]

Large Nested Variant of Urothelial Carcinoma

2011 ◽  
Vol 35 (9) ◽  
pp. 1337-1342 ◽  
Author(s):  
Roni Cox ◽  
Jonathan I. Epstein
Keyword(s):  
Urothelial Carcinoma ◽  
Nested Variant
Sign in / Sign up

Export Citation Format

Share Document