Unconventional radiotherapy to enhance immunotherapy efficacy in bulky tumors: a case report

Immunotherapy ◽  
2021 ◽  
Author(s):  
Mariangela Massaccesi ◽  
Luca Boldrini ◽  
Angela Romano ◽  
Ernesto Rossi ◽  
Giovanni Schinzari ◽  
...  
Keyword(s):  
Case Report ◽  
Management Strategy ◽  
Checkpoint Inhibitors ◽  
Cell Cancer ◽  
Sequential Therapy ◽  
Large Tumor ◽  
Tumor Lesion ◽  
Third Line Therapy ◽  
Fractionated Radiation Therapy ◽  
Third Line

Determining the most appropriate management strategy for patients with large tumor masses is a very challenging issue. Unconventional radiotherapy modalities, such as spatially fractionated radiation therapy (SFRT), are associated with dramatic responses. Recent studies have suggested that systemic immune activation may be triggered by SFRT delivery to primary tumor lesion. This report describes the case of a patient treated with a novel form of immune-sparing partially ablative irradiation (ISPART) for a bulky peritoneal metastasis from renal cell cancer, refractory to anti-PD-1 therapy (nivolumab) as third-line therapy after sequential therapy with sunitinib and cabozantinib. The observed response suggests that there may be a synergistic effect between ISPART and immunotherapy. This case report supports the inclusion of ISPART in patients presenting with bulky lesions treated with checkpoint inhibitors .

Phase II study of recombinant IL-21 (rIL-21) plus sorafenib as second- or third-line therapy for metastatic renal cell cancer (mRCC): Final results

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 3023-3023 ◽  
Author(s):  
S. Bhatia ◽  
E. Heath ◽  
I. Puzanov ◽  
W. Miller ◽  
B. Curti ◽  
...  
Keyword(s):  
Phase Ii ◽  
Phase Ii Study ◽  
Cell Cancer ◽  
Single Agent ◽  
Cell Activity ◽  
Unmet Need ◽  
Line Therapy ◽  
Third Line Therapy ◽  
Third Line ◽  
Line Setting

3023 Background: Despite the positive impact of targeted therapies on treatment for mRCC, the efficacy of these agents appears to decrease beyond the first-line setting. There is an unmet need for novel therapies after failure of vascular endothelial growth factor (VEGF)-directed agents. rIL-21, a cytokine that enhances CD8+ T-cell and NK cell activity, has single-agent antitumor activity (J Clin Oncol. 2008;26:2034). Based on promising results of a phase I study of rIL-21 plus sorafenib, we initiated a phase II study to explore the safety and efficacy of this combination as second- or third-line treatment for mRCC. Methods: Patients with mRCC received second- or third-line therapy with sorafenib 400 mg PO BID continuously plus rIL-21 30 μg/kg IV on days 1–5 and 15–19 of each 7-week treatment course (TC). Efficacy endpoints included progression-free survival (PFS) and overall response rate (ORR) per RECIST. Response was assessed by the investigator and by independent radiologic review (IRR). Results: 33 patients were enrolled from 14 sites in the U.S. and Canada. Median age was 61 years (range, 46–75); ECOG performance status was 0 (n=15) or 1 (n=18). Patients had received 1 (n=25) or 2 (n=8) prior lines of therapy, including sunitinib (n=19), temsirolimus (n=5), bevacizumab (n=3), everolimus (n=2), IL-2 (n=11), or other (n=4). Grade ≥3 adverse events considered at least possibly related to study drug and occurring in ≥3 patients included hypophosphatemia (33%), hand-foot syndrome (24%), rash (24%), thrombocytopenia (8%), and neutropenia (8%). Twelve patients remain on study; 13 withdrew for progressive disease (PD), 6 for toxicity, and 2 for other reasons. IRR has been performed for the first 23 patients who completed at least 1 full TC, with 6 confirmed PR (26%), 1 unconfirmed PR (4%), 14 SD (61%), and 2 PD (9%). While median PFS cannot yet be determined, 14 of the first 29 patients have completed at least 3 TCs, equivalent to approximately 21 weeks, with SD or better. Conclusions: rIL-21 plus sorafenib is associated with an acceptable safety profile and promising antitumor efficacy in previously treated patients with mRCC. The observed ORR to date compares favorably with the rate previously reported for sorafenib in the first and second-line setting. [Table: see text]

scholarly journals Unexpected Favorable Outcome to PD-1 Antibody Plus Lenvatinib in a Patient With Recurrent Intestinal Follicular Dendritic Cell Sarcoma: A Case Report and Literature Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Yanna Lei ◽  
Sha Zhao ◽  
Ming Jiang
Keyword(s):  
Case Report ◽  
Dendritic Cell ◽  
Checkpoint Inhibitors ◽  
Follicular Dendritic Cell ◽  
Antiangiogenic Agents ◽  
Follicular Dendritic Cell Sarcoma ◽  
Cell Sarcoma ◽  
Dendritic Cell Sarcoma ◽  
Follicular Dendritic ◽  
Third Line

BackgroundFollicular dendritic cell sarcoma (FDCS) is an uncommon malignant cancer, and there is no standard treatment to date. Resection followed by adjuvant chemotherapy or radiation is considered the most commonly used strategy for treatment. However, the treatment for patients who have progressed after systemic treatment is more controversial.Case summaryIn this case report, we describe a 57-year-old man with primary small intestine FDCS where surgery and second-line systemic chemotherapy failed. After disease progression (PD), the patient received sintilimab plus lenvatinib as third-line treatment and achieved a progression-free survival (PFS) with 7 months.ConclusionThis is the first report of a FDCS patient treated with immune checkpoint inhibitors (ICIs) and antiangiogenic agents, sintilimab and lenvatinib, as third-line therapy. Our case provides a potential therapeutic option for patients with FDCS who progressed after multiline therapy.

scholarly journals Extraordinary and prolonged Erlotinib-induced clinical response in a patient with EGFR wild-type squamous lung cancer in third-line therapy: a case report

2017 ◽  
Vol Volume 10 ◽  
pp. 173-175 ◽  
Author(s):  
Elisabetta Gambale ◽  
Consiglia Carella ◽  
Paolo Amerio ◽  
Fiamma Buttitta ◽  
Rosa Lucia Patea ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Clinical Response ◽  
Wild Type ◽  
Line Therapy ◽  
Squamous Lung Cancer ◽  
Third Line Therapy ◽  
Third Line

Notable response to nivolumab during the treatment of SMARCA4-deficient thoracic sarcoma: a case report

Immunotherapy ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 563-569 ◽  
Author(s):  
Yuki Iijima ◽  
Rie Sakakibara ◽  
Masahiro Ishizuka ◽  
Takayuki Honda ◽  
Tsuyoshi Shirai ◽  
...  
Keyword(s):  
Case Report ◽  
Mediastinal Mass ◽  
Immune Checkpoint Inhibitor ◽  
Tumor Regression ◽  
Checkpoint Inhibitor ◽  
Unknown Primary ◽  
Therapeutic Effects ◽  
First Case ◽  
Third Line Therapy ◽  
Third Line

SMARCA4-deficient thoracic sarcoma is a rare tumor typically presenting as a mediastinal mass. The prognosis is estimated to be poor, and no effective treatment has been established. We present a case of a 76-year-old man who was diagnosed with SMARCA4-deficient thoracic sarcoma. The provisional diagnosis was carcinoma of unknown primary but subsequently corrected to SMARCA4-deficient thoracic sarcoma based on the panel-based cancer gene screening and immunohistochemistry. Cytotoxic chemotherapy as the first- and second-line did not reveal enough therapeutic effects but third-line therapy using nivolumab showed marked tumor regression, which was sustained. This is the first case report of SMARCA4-deficient thoracic sarcoma showing a good response to nivolumab. Immune checkpoint inhibitor might be therapeutic candidates for this type of tumor.

scholarly journals Phase II Study of S-1 Monotherapy as a First-line, Combination Therapy of S-1 plus Cisplatin as a Second-line, and Weekly Paclitaxel Monotherapy as a Third-line Therapy in Patients with Advanced Gastric Carcinoma

2008 ◽  
Vol 2 ◽  
pp. CMO.S610
Author(s):  
Yasushi Rino ◽  
Norio Yukawa ◽  
Nobuyuki Wada ◽  
Makoto Suzuki ◽  
Hitoshi Murakami ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adverse Effect ◽  
Phase Ii Study ◽  
Sequential Therapy ◽  
Second Line ◽  
First Line ◽  
Line Therapy ◽  
Third Line Therapy ◽  
Third Line ◽  
Line Chemotherapy

Background We conducted a pilot phase II study to evaluate the efficacy and safety of S-1 as a first-line, S-1 plus cisplatin as a second-line, and weekly paclitaxel as a third-line therapy for advanced gastric cancer. Patients and Methods Between 2002 and 2005, 19 patients were enrolled in this study. Chemotherapy consisted of either 60 mg/m2 of S-1 for 4 weeks at 6 weeks interval, a combination of 60 mg/m2 S-1 for 3 weeks and 60 mg/m2 cisplatin on day 8 at 5 weeks interval, or 60 mg/m2 paclitaxel at day 1, 8, 15, at 4 weeks interval. The regimen was repeated until the occurrence of unacceptable toxicities, disease progression, or patient refusal. The primary end point was the overall survival. Results The response rates were 33.3%, 12.5%, and 0% after the first, second, and third line chemotherapy, respectively. The mean overall survival time was 994 days. The median survival time could not be calculated because 12 out of 19 patients were still alive when the study was concluded. Regarding hematological toxicity, the major adverse effect was leukopenia, which reached grades 3–4 in all lines of chemotherapy investigated. In addition, regarding non-hematological toxicities, the major adverse effect was anorexia, which reached grade 3–4 in the second line chemotherapy, and no deaths were attributable to the adverse effects of the drugs. Conclusion This sequential therapy was an effective treatment for advanced gastric cancer with acceptable toxic side-effects. We considered this sequential therapy to be effective because of the smooth switch to the next regimen.

Popliteal nodal metastasis from squamous cell cancer of the foot. Case report and literature review

2019 ◽  
pp. 1-2
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Literature Review ◽  
Squamous Cell ◽  
Rare Case ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Nodal Metastasis ◽  
Regional Disease ◽  
The Right

We report a very rare case of squamous cell cancer of the right foot which had metastasize to the ipsilateral popliteal lymph node after initial diagnosis and treatment for the loco-regional disease.

scholarly journals H2-antagonist in IgE-mediated type I hypersensitivity reactions: what literature says so far?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Matteo Borro ◽  
Simone Negrini ◽  
Andrew Long ◽  
Sharon Chinthrajah ◽  
Giuseppe Murdaca
Keyword(s):  
Receptor Antagonist ◽  
Inflammatory Responses ◽  
Type I ◽  
Line Therapy ◽  
H2 Antagonist ◽  
Amino Acid Histidine ◽  
Third Line Therapy ◽  
Ige Mediated ◽  
Third Line ◽  
Type I Hypersensitivity

AbstractHistamine is a monoamine synthesized from the amino acid histidine that is well-known for its role in IgE-mediated anaphylaxis but has shown pleiotropic effects on the immune system, especially in order to promote inflammatory responses. H1-receptor antagonist are common drugs used in mild/moderate allergic reactions whereas H2-receptor antagonist are commonly administered in gastric ulcer but showed some properties in allergy too. The EAACI guidelines for diagnosis and treatment of anaphylactic reactions recommend their use as third-line therapy in adjunct to H1-antagonists. The purpose of this article is to produce a complete summary of findings and evidence known so far about the usefulness of H2-receptor antagonist in allergic reactons.

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