Pushing the limits of immune-related response: a case of “extreme pseudoprogression”
We describe a case of pseudoprogression that pushes the limits of immune-related response criteria and challenges the boundaries and definitions set by trial protocols. A middle-aged man with conventional clear cell renal cell carcinoma (RCC) had received multiple prior systemic treatments including vascular endothelial growth factor receptor tyrosine kinase inhibitors, as well as multiple surgeries and radiotherapy treatments. He was eventually started on nivolumab —the anti-programmed death receptor-1 monoclonal antibody approved for the treatment of advanced RCC. Clinical deterioration was observed soon after a 100 mg dose of nivolumab, with onset of acute renal failure and declining performance status. Radiologic progression was documented in multiple si tes including worsening tumor infiltration of his residual kidney. The patient was on palliative treatment and visited by the home hospice team in an end-of-life situation. The patient unexpectedly improved and went on to achieve a durable tumor response. The case is illustrative of an extreme manif estation of pseudoprogression, and impels us to probe the assumptions and controversies surrounding this phenomenon.
Authors: Hoffmann TK PMID: 32060569 [PubMed - as supplied by publisher]
This study aimed at comparing risk of recurrence and response to therapy of PTC with mETE and gross ETE into the strap muscles (gETE) to low- and intermediate-risk PTC without ETE (low w/o ETE and intermediate w/o ETE) to further characterize the impact of ETE on outcomes. METHODS: 596 PTCs were analyzed according to degree of ETE and other predictors of recurrence. Four groups of patients were compared, low w/o ETE (n=251), intermediate w/o ETE (n=89), mETE (n=191) and gETE (n=65), to determine the risk of recurrence and the response to treatment. Cox proportional hazards models were used to investigate associations b...
(RMIT University) About 300,000 new cases of ovarian cancer are diagnosed globally each year, with about 60% of women dying within five years after diagnosis. A clinical trial has shown testing for a specific immune biomarker could improve diagnosis.
(American Cancer Society) A new study finds a wide state-by-state variation in rates of melanoma caused by ultraviolet (UV) exposure with highest rates in several states on the East and West Coast including Hawaii, but also a few landlocked states, including Utah, Vermont, and Minnesota.
We report a case of a 63-year-old female admitted to the hospital due to abdominal pain, nausea, vomiting and elevated blood pressure. One month earlier, sunitinib therapy for metastatic renal cell carcinoma was initiated. During the first cycle of therapy, after three weeks of sunitinib 50 mg daily, symptoms started and she stopped taking the drug. At admission, laboratory tests revealed elevated serum and urine amylase, C-reactive protein, urea and creatinine, and lowered platelet and leukocyte counts and hemoglobin value. Urine test showed proteinuria, erythrocyturia, leukocyturia and granulated cylinder. The patient wa...
This report is about a patient with metastastic squamous cell cancer of the head and neck refractory to nivolumab monotherapy, who showed a remarkable response to combination therapy with nivolumab and ipilimumab over a period of 2 years, but developed serious renal failure and a Takotsubo cardiomyopathy.
Though radical cytoreductive nephrectomy has been shown to improve overall survival in patients with metastatic renal cell carcinoma, the impact this treatment has on renal function has not been adequately assessed. Radical nephrectomy in patients with localized cancer has been associated with risk of chronic kidney disease development. Using patients enrolled in ADAPT trial that received cytoreductive nephrectomy in the metastatic setting, we intend to study the effect of this procedure on overall renal function in patients without kidney disease.
CONCLUSIONS: Our data showed that morphine promotes RCC growth and increases RCC progression via over-expression of Survivin. PMID: 27866460 [PubMed - as supplied by publisher]
This study describes the natural history of renal function after radical and partial nephrectomy and explores factors associated with postoperative decline in renal function. METHODS: This is a multi-institutional cohort study of patients in the Canadian Kidney Cancer Information System who underwent partial or radical nephrectomy for RCC. Estimated glomerular filtration rate (eGFR) and stage of chronic kidney disease were determined preoperatively and at 3, 12, and 24 months postoperatively. Linear regression was used to determine the association between postoperative eGFR and type of surgery (radical vs. partial), d...