Hyperprogression after anti-programmed death-1 therapy in a patient with urothelial bladder carcinoma:A case report  

作　　者：Hong-Yu Yang Yu-Xuan Du Yu-Jia Hou Dian-Rong Lu Peng Xue 

机构地区：[1]Department of Oncology,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100000,China [2]Department of Oncology,Tianjin University of Chinese Medicine,Tianjin 300000,China [3]Traditional Chinese Medical Science,Tianjin University of Chinese Medicine,Tianjin 300000,China

出　　处：《World Journal of Clinical Cases》2023年第28期6841-6849,共9页世界临床病例杂志

基　　金：Supported by the National Natural Science Foundation,No.81973640.

摘　　要：BACKGROUND Immune checkpoint inhibitors,including programmed death-ligand 1(PD-L1)and programmed death-1(PD-1)have recently been approved to treat locally advanced and metastatic urothelial carcinoma(UC).However,some patients experience rapid tumor progression rather than any clinical benefit from anti-PDL1/PD-1 therapy.CASE SUMMARY A 73-year-old woman with bladder UC showed the progression of multiple metastases after surgery and chemotherapy for over 12 mo.The patient could not tolerate further chemotherapy.Next-generation sequencing was performed,and the results indicated that the tumor mutational burden was 6.4 mutations/Mb.The patient received the anti-PD-L1 agent toripalimab combined with albuminbound paclitaxel.Compared with the baseline staging before immunotherapy,the patient had a treatment failure time of<2 mo,an increase in tumor burden of>50%,and a>2-fold increase in progression,indicating hyperprogression.CONCLUSION Selecting patients most likely to respond to treatment with immunotherapeutic agents remains challenging.For older patients with advanced UC who have already exhausted multi-line chemotherapy options,immunotherapy should be used prudently if no effective biomarker is available.Further studies are required to clarify the causes and mechanisms of hyperprogression.

关 键 词：Bladder urothelial carcinoma Hyperprogression IMMUNOTHERAPY Toripalimab Case report 

分 类 号：R737.14[医药卫生—肿瘤]