Title |
Pseudoprogression manifesting as recurrent ascites with anti-PD-1 immunotherapy in urothelial bladder cancer
|
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Published in |
Journal for Immunotherapy of Cancer, April 2018
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DOI | 10.1186/s40425-018-0334-x |
Pubmed ID | |
Authors |
Randy F. Sweis, Yuanyuan Zha, Lomax Pass, Brian Heiss, Tara Chongsuwat, Jason J. Luke, Thomas F. Gajewski, Russell Szmulewitz |
Abstract |
Immunotherapies targeting the PD-1 checkpoint pathway have recently gained regulatory approval in numerous cancer types. With the widespread use of immune checkpoint therapies, varying patterns of responses and immune-related adverse events are being observed. In this case, we highlight a patient who developed recurrent, large-volume ascites, while simultaneously having a 49% reduction in peritoneal tumor lesion size by RECIST criteria. Sampling of the fluid revealed high levels of IL-6 and IL-15. Cytology revealed no malignant cells on 4 separate paracenteses over a period of 6 weeks. Cell counts revealed that 45% of cells were lymphocytes, and further analysis was performed by fluorescence-activated cell sorting (FACS). The majority of lymphocytes were CD8+, of which 78% were PD-1+and 43% were HLA-DR+indicating an activated phenotype. In summary, treatment with anti-PD-1 therapy may result in pseudoprogression manifested by ascitic fluid accumulation due to the influx of activated T cells. Since worsening of ascites is typically associated with disease progression, it is important to consider the possibility of pesudoprogression in such patients undergoing therapy with immune checkpoint inhibitors. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 13 | 35% |
Mexico | 5 | 14% |
Spain | 2 | 5% |
Sweden | 1 | 3% |
Brazil | 1 | 3% |
India | 1 | 3% |
Belgium | 1 | 3% |
Unknown | 13 | 35% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 24 | 65% |
Practitioners (doctors, other healthcare professionals) | 7 | 19% |
Scientists | 5 | 14% |
Science communicators (journalists, bloggers, editors) | 1 | 3% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 27 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 6 | 22% |
Student > Master | 3 | 11% |
Student > Ph. D. Student | 3 | 11% |
Lecturer | 2 | 7% |
Student > Postgraduate | 2 | 7% |
Other | 6 | 22% |
Unknown | 5 | 19% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 15 | 56% |
Veterinary Science and Veterinary Medicine | 1 | 4% |
Biochemistry, Genetics and Molecular Biology | 1 | 4% |
Unspecified | 1 | 4% |
Social Sciences | 1 | 4% |
Other | 1 | 4% |
Unknown | 7 | 26% |