Please use this identifier to cite or link to this item: https://doi.org/10.1007/s00262-018-2167-3
Title: Pushing the limits of immune-related response: a case of “extreme pseudoprogression”
Authors: Wong, A.S 
Thian, Y.-L 
Kapur, J 
Leong, C.-N 
Kee, P
Lee, C.-T
Lee, M.B
Keywords: alkaline phosphatase
axitinib
calcium
creatinine
denosumab
everolimus
gabapentin
hemoglobin
interleukin 2
lactate dehydrogenase
nivolumab
pazopanib
prednisolone
sunitinib
tramadol
antineoplastic agent
monoclonal antibody
nivolumab
programmed death 1 receptor
acute kidney failure
adult
anemia
antiangiogenic therapy
Article
backache
bone metastasis
brain metastasis
calcium blood level
cancer immunotherapy
cancer palliative therapy
cancer radiotherapy
cancer regression
case report
clinical article
computer assisted tomography
creatinine blood level
deterioration
disease course
drug dose reduction
drug megadose
dyspnea
Eastern Cooperative Oncology Group score
echography
edema
erythrocyte transfusion
external beam radiotherapy
extreme pseudoprogression
functional status assessment
general condition improvement
hematuria
hemodialysis
hemolysis
home care
hospice care
human
hypercalcemia
hyperkalemia
immune related response criteria
male
middle aged
oliguria
oncogenesis and malignant transformation
outcome assessment
priority journal
renal cell carcinoma
response evaluation criteria in solid tumors
side effect
single drug dose
spine metastasis
systemic therapy
terminal care
thorax radiography
treatment response
tumor volume
urine volume
antagonists and inhibitors
disease exacerbation
immunology
immunotherapy
kidney tumor
pathology
renal cell carcinoma
Antibodies, Monoclonal
Antineoplastic Agents
Carcinoma, Renal Cell
Disease Progression
Humans
Immunotherapy
Kidney Neoplasms
Male
Middle Aged
Programmed Cell Death 1 Receptor
Issue Date: 2018
Publisher: Springer Science and Business Media Deutschland GmbH
Citation: Wong, A.S, Thian, Y.-L, Kapur, J, Leong, C.-N, Kee, P, Lee, C.-T, Lee, M.B (2018). Pushing the limits of immune-related response: a case of “extreme pseudoprogression”. Cancer Immunology, Immunotherapy 67 (7) : 1105-1111. ScholarBank@NUS Repository. https://doi.org/10.1007/s00262-018-2167-3
Rights: Attribution 4.0 International
Abstract: The advent of immune checkpoint targeted immunotherapy has seen a spectrum of immune-related phenomena in both tumor responses and toxicities. 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 sites 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 manifestation of pseudoprogression, and impels us to probe the assumptions and controversies surrounding this phenomenon. © 2018, The Author(s).
Source Title: Cancer Immunology, Immunotherapy
URI: https://scholarbank.nus.edu.sg/handle/10635/179031
ISSN: 03407004
DOI: 10.1007/s00262-018-2167-3
Rights: Attribution 4.0 International
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