Pathological complete response to pembrolizumab in patients with metastatic ascending colon cancer with microsatellite instability
| العنوان: | Pathological complete response to pembrolizumab in patients with metastatic ascending colon cancer with microsatellite instability |
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| المؤلفون: | Takeshi Nagayasu, Shinji Okano, Masaaki Moriyama, Tetsuro Tominaga, Shosaburo Oyama, Mitsutoshi Ishii, Takashi Nonaka, Terumitsu Sawai, Akiko Fukuda |
| المصدر: | Clinical Journal of Gastroenterology. 15:134-139 |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Colorectal cancer, Pembrolizumab, Antibodies, Monoclonal, Humanized, Colon, Ascending, Biopsy, medicine, Humans, Stage (cooking), Lymph node, FOLFOXIRI, medicine.diagnostic_test, business.industry, Gastroenterology, General Medicine, Middle Aged, Swollen lymph nodes, medicine.disease, medicine.anatomical_structure, Colonic Neoplasms, Adenocarcinoma, Microsatellite Instability, Radiology, medicine.symptom, business |
| الوصف: | Pembrolizumab is a novel immune-checkpoint inhibitor used for treatment of microsatellite instability-high (MSI-H) colorectal cancer. Several studies have reported clinical complete response (CR) after treatment with pembrolizumab, but none has confirmed pathological CR. Here we provide the first description of pathological CR with R0 resection after immune-checkpoint therapy. A 45-year-old man presented at our hospital with abdominal distention and highly elevated tumor markers. Contrast-enhanced abdominal CT showed a 110 × 75 mm bulky mass with markedly swollen lymph nodes and an isolated peritoneal metastasis in the pelvic space. Biopsy revealed poorly differentiated adenocarcinoma. We diagnosed ascending colon cancer cT4aN2bM1c Stage IVc. A biopsy specimen obtained during systemic chemotherapy (FOLFOXIRI) was confirmed pathologically as MSI-H, after which the treatment was changed to pembrolizumab. The tumor markers rapidly decreased to within normal ranges after three courses of treatment. After twenty courses, CT revealed shrinkage of the main tumor, lymph node metastases, and the peritoneal metastasis, and we performed extended right hemi-colectomy with dissection of the peritoneal metastasis. No residual tumor cells were found histologically. The patient achieved pathological CR and the postoperative course was uneventful. An accurate diagnosis and appropriate follow up are crucial for obtaining sufficient therapeutic effect of pembrolizumab. |
| تدمد: | 1865-7265 1865-7257 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ce5e9026bfc9e8d2717731fcb61eaae2Test https://doi.org/10.1007/s12328-021-01543-yTest |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....ce5e9026bfc9e8d2717731fcb61eaae2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18657265 18657257 |
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