Efficacy of Enfortumab Vedotin After Chemotherapy With Anti-programmed Death-Ligand 1 (PD-L1) Maintenance Treatment in a Clear Cell Variant of Invasive Urothelial Carcinoma of the Renal Pelvis: A Case Report

Among upper urinary tract urothelial carcinoma (UUTUC) cases, there are few reports of the clear cell variant. Systemic chemotherapy will be given according to the usual treatment for urothelial cancer unless lymph nodes or organ metastases make surgical treatment inappropriate. Here, we report a cl...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-03, Vol.16 (3), p.e55766
Main Authors: Hirata, Hiroshi, Hoshii, Yoshinobu, Ito, Hideaki, Tsuzuki, Toyonori, Shiraishi, Koji
Format: Article
Language:English
Subjects:
Back pain
Biomarkers
Biopsy
Cancer therapies
Case reports
Cell death
Chemotherapy
Cytokeratin
Disease
Histology
Kidney cancer
Ligands
Lymphatic system
Medical prognosis
Metastasis
Monoclonal antibodies
Oncology
Pathology
Pelvis
Prostate cancer
Proteins
Radiation therapy
Surgery
Targeted cancer therapy
Tumors
Urogenital system
Urological cancer
Urology
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Summary:Among upper urinary tract urothelial carcinoma (UUTUC) cases, there are few reports of the clear cell variant. Systemic chemotherapy will be given according to the usual treatment for urothelial cancer unless lymph nodes or organ metastases make surgical treatment inappropriate. Here, we report a clear cell variant of UUTUC of the left renal pelvis with aortic lymph node metastasis. The patient in this case was treated with systemic chemotherapy, anti-programmed death-ligand 1 (PD-L1) maintenance treatment, radiation therapy, and enfortumab vedotin (EV) therapy. To determine which of the treatments contributed to the therapeutic effect, immunostaining was used. The results indicated that Nectin-4 was expressed in clear cell variant tissues, while programmed cell death protein 1 (PD-1) and PD-L1 expression levels were weak in these tissues. The patient maintained complete remission with these treatments. Two years after the initial treatment, the patient was still alive with no progression or metastasis.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.55766