Multidisciplinary consultation on difficult cases in Guangdong Urological Association （Phase 15）: comprehensive treatment of metastatic bladder cancer

doi:10.3877/cma.j.issn.1674-3253.2024.06.019

Abstract

Abstract:

This article reports a case with high-grade invasive urothelial carcinoma of the bladder. The patient was diagnosed as bladder cancer with multiple lymph node metastasis and penis metastasis two years ago. On June 22，2022，he was treated with Gemcitabine+Cisplatin （GC） combined with Lirilumab after diagnostic transurethral resection of bladder tumor（TURBT）. On November 23，2022，a follow-up examination revealed multiple lesions in the bladder involving the muscular layer. Immune maintenance therapy was continued，along with pelvic radiotherapy. In June 2023，immunotherapy was temporarily suspended due to hypothyroidism and later resumed. On December 4，2023，multiple lymph node metastases were still found during the follow-up examination. After a multidisciplinary consultation on difficult cases in Guangdong Urological Association，it is recommended that the patient be treated with Disitamab Vedotin combined with Toripalimab q2w for 6 cycles. After treatment，the patient's transurethral resection and biopsy did not show any cancer lesions，and the lymph nodes were significantly reduced or disappeared compared to before.Therefore，for advanced urothelial carcinoma with isolated metastatic lesions，based on evidence-based medicine，selecting first-line treatment options that include immunotherapy in combination with radiotherapy can further benefit.After the progress of first-line treatment，the immune "re-challenge" can still benefit，and the combination of immune and antibody conjugated drugs is an optional solution.

Key words: Bladder cancer, MIBC, Lymphatic metastasis, HER2, PD-L1, Immunotherapy, ADC

Yi Lin, Wenlong Zhong, Kaiwen Li, Wang He, Tianxin Lin. Multidisciplinary consultation on difficult cases in Guangdong Urological Association （Phase 15）: comprehensive treatment of metastatic bladder cancer[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(06): 648-652.

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