scholarly journals Complete pathological response of colorectal peritoneal metastases in Lynch syndrome after immunotherapy case report: is a paradigm shift in cytoreductive surgery needed?

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Marco Tonello ◽  
Floriana Nappo ◽  
Loretta Vassallo ◽  
Rosa Di Gaetano ◽  
Carla Davoli ◽  
...  
Keyword(s):  
Case Report ◽  
Lynch Syndrome ◽  
Cytoreductive Surgery ◽  
Pathological Complete Response ◽  
Residual Disease ◽  
Checkpoint Inhibitors ◽  
Disease Patient ◽  
Complete Response ◽  
Peritoneal Metastases ◽  
First Case

Abstract Background We report the first case of a patient affected by peritoneal metastases from colon cancer, arising in the context of Lynch syndrome with pathological complete response. The patient was treated with immunotherapy and cytoreductive surgery. This paper discusses the implications of these novel therapies for the management of PM. Case presentation A 50-year-old man affected by Lynch syndrome was referred to our institution for metachronous peritoneal recurrence of ascending colon adenocarcinoma. As a second-line treatment, he received Nivolumab therapy with stable disease. Patient underwent cytoreductive surgery with residual disease and a pathological complete response. Flow cytometry described a particular immune sub-population response. There was no evidence of disease progression after nine months. Conclusion This is the first report of a Lynch patient affected by peritoneal metastases of colorectal cancer, treated with cytoreductive surgery (CRS) and resulting in a pathological complete response after immune checkpoint inhibitors treatment (ICIs). This case report may suggest that patients with peculiar immunological features could benefit from a tailored approach, since “classical” CRS paradigms may not effectively predict the clinical outcome. Further large-scale studies are needed to determine the correct operative management of such patients (tailored or “standard” CRS), defining the correct surgical timing and eventual discontinuation of ICI therapy after surgery.

scholarly journals PD-L1 Expression after Neoadjuvant Chemotherapy in Triple-Negative Breast Cancers Is Associated with Aggressive Residual Disease, Suggesting a Potential for Immunotherapy

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 746
Author(s):  
Beatriz Grandal ◽  
Manon Mangiardi-Veltin ◽  
Enora Laas ◽  
Marick Laé ◽  
Didier Meseure ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Triple Negative ◽  
Residual Disease ◽  
Checkpoint Inhibitors ◽  
Rapid Development ◽  
Complete Response ◽  
Tumor Burden ◽  
Small Subset ◽  
Breast Cancers ◽  
Residual Cancer Burden

The consequences of neoadjuvant chemotherapy (NAC) for PD-L1 activity in triple-negative breast cancers (TNBC) are not well-understood. This is an important issue as PD-LI might act as a biomarker for immune checkpoint inhibitors’ (ICI) efficacy, at a time where ICI are undergoing rapid development and could be beneficial in patients who do not achieve a pathological complete response. We used immunohistochemistry to assess PD-L1 expression in surgical specimens (E1L3N clone, cutoff for positivity: ≥1%) on both tumor (PD-L1-TC) and immune cells (PD-L1-IC) from a cohort of T1-T3NxM0 TNBCs treated with NAC. PD-L1-TC was detected in 17 cases (19.1%) and PD-L1-IC in 14 cases (15.7%). None of the baseline characteristics of the tumor or the patient were associated with PD-L1 positivity, except for pre-NAC stromal TIL levels, which were higher in post-NAC PD-L1-TC-positive than in negative tumors. PD-L1-TC were significantly associated with a higher residual cancer burden (p = 0.035) and aggressive post-NAC tumor characteristics, whereas PD-L1-IC were not. PD-L1 expression was not associated with relapse-free survival (RFS) (PD-L1-TC, p = 0.25, and PD-L1-IC, p = 0.95) or overall survival (OS) (PD-L1-TC, p = 0.48, and PD-L1-IC, p = 0.58), but high Ki67 levels after NAC were strongly associated with a poor prognosis (RFS, p = 0.0014, and OS, p = 0.001). A small subset of TNBC patients displaying PD-L1 expression in the context of an extensive post-NAC tumor burden could benefit from ICI treatment after standard NAC.

PS02.182: EFFECTIVENESS OF ANTI-PD-1 ANTIBODY MONOTHERAPY FOR THE PRIMARY MALIGNANT MELANOMA OF THE ESOPHAGUS: A CASE REPORT

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 173-174
Author(s):  
Hiroto Muroi ◽  
Masanobu Nakajima
Keyword(s):  
Case Report ◽  
Malignant Melanoma ◽  
Conflicts Of Interest ◽  
Complete Response ◽  
Primary Malignant Melanoma ◽  
Innovative Strategies ◽  
First Case ◽  
Positron Emission ◽  
Programmed Death ◽  
Programmed Death 1

Abstract Background Primary malignant melanoma of the esophagus (PMME) is extraordinarily rare with a high prevalence of malignancy and poor prognosis, and a standard therapy remains to be established. Since conventional therapeutic methods have been limited in their effects on treatment outcomes, innovative strategies for treating PMME are being explored, especially molecular targeting strategies. The programmed death 1 (PD-1) protein/programmed death ligand-1(PD-L1) inhibitor nivolumab is a promising agent for various cancers. To our knowledge, this is the first case report of PMME where a complete response was achieved using nivolumab. Methods We report an 80-year-old woman who was diagnosed with PMME with bone metastasis and lymph node metastases. Although dacarbazine combined chemotherapy was performed and continued for six cycles, the primary tumor deteriorated and liver metastases appeared. The patient then received nivolumab monotherapy (2 mg/kg, once every three weeks). Results After three cycles, nivolumab monotherapy for PMME resulted in a complete response as shown by positron emission tomography, computed tomography, and esophagogastroduodenoscopy. Conclusion In our case, nivolumab exerted a curative effect on PMME, thus suggesting that nivolumab can be effective in the treatment of this rare disease. Disclosure All authors have declared no conflicts of interest.

Bluish-gray fingernail discoloration due to the use of nivolumab

2020 ◽  
pp. 107815522092997
Author(s):  
Miguel Michel Ocampo ◽  
Jaren Lerner ◽  
Constantin A Dasanu
Keyword(s):  
Case Report ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Skin Toxicity ◽  
Unique Case ◽  
First Case ◽  
Nail Discoloration ◽  
Wide Range ◽  
Causality Relationship

Introduction Immune checkpoint inhibitors have improved clinical outcomes in a wide range of cancers. While skin toxicity is not uncommon with immune checkpoint inhibitors, generalized nail discoloration has not been reported with their use in oncology. Case report Herein, we report a unique case of bluish-gray fingernail discoloration due to nivolumab therapy for relapsed melanoma. Management and outcome: This condition reversed completely 10 weeks after nivolumab discontinuation. Naranjo nomogram assessment renders the causality relationship between nivolumab and nail discoloration probable. Discussion To our knowledge, this is the first case report of an unusual bluish-gray nail discoloration due to therapy with nivolumab. The mechanism by which nivolumab causes this side effect remains to be elucidated.

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