高级别浸润性膀胱癌在维迪西妥单抗新辅助治疗后行根治性膀胱切除术1例

刘磊; 乐昶捷; 张远鹏; 车建强; 李侃; 蒋国松; 章小平

doi:10.13201/j.issn.1001-1420.2022.12.015

高级别浸润性膀胱癌在维迪西妥单抗新辅助治疗后行根治性膀胱切除术1例

- 华中科技大学同济医学院附属协和医院泌尿外科(武汉，430022)
基金项目:
国家自然科学基金项目(No：82102787)

详细信息

通讯作者: 蒋国松，E-mail：jgs017@126.com

中图分类号: R737.14

收稿日期: 2022-10-10

刊出日期: 2022-12-06

A case report of high-grade muscle-invasive bladder cancer undergoing radical cystectomy after neoadjuvant therapy with RC48

- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

More Information

Corresponding author: JIANG Guosong: E-mail: jgs017@126.com

Received Date: 10 October 2022

Publish Date: 06 December 2022

摘要

摘要: 报道1例高级别浸润性膀胱癌在维迪西妥单抗新辅助治疗后行根治性膀胱切除术(RC)的治疗效果，探讨新辅助治疗对此类患者的临床意义。1例70岁男性膀胱癌患者，因多支冠状动脉(冠脉)狭窄，需行冠脉旁路移植术(CABG)，在CABG围手术期(3个月内)暂时无法耐受RC手术。患者在局麻下行膀胱镜检查术，活检病理提示：高级别尿路上皮癌，HER2(2+)，PD-L1(CPS=2)。综合考虑患者肿瘤的病理类型、免疫组化结果以及患者经济情况，对患者行维迪西妥单抗(RC48)新辅助治疗，CABG术后3个月行RC手术。结果显示，患者在CABG术后2周开始行维迪西妥单抗新辅助治疗，每次120 mg，每2周1次，共治疗4次，期间复查2次CTU显示肿瘤负荷明显缩小，达到部分缓解，疾病得到了有效控制。在CABG术后3个月，对患者行RC手术。术后病理检查提示膀胱高级别浸润性尿路上皮癌，T_2bN₀M₀，切缘阴性。维迪西妥单抗为代表的抗体药物偶联物的新辅助治疗具有光明的前景，值得进一步探究。
- 膀胱癌 /
- 新辅助治疗 /
- 维迪西妥单抗 /
- 抗体药物偶联物
Abstract: We reported the efficacy of radical cystectomy (RC) after neoadjuvant therapy with RC48 for a case of high-grade muscle-invasive bladder cancer so as to explore the clinical significance of neoadjuvant therapy for this kind of patients. A 70-year-old male patient with bladder cancer underwent coronary artery bypass grafting (CABG) due to multiple coronary artery stenosis. During the perioperative period of CABG (within 3 months), RC was temporarily unable to be tolerated. Cystoscopy was performed under local anesthesia. Considering the pathological type of the tumor, the results of immunohistochemistry and the economic situation of the patient, the patient was treated with RC48 neoadjuvant therapy, and RC was performed three months after CABG. Then two weeks after CABG, the patient was treated with RC48 neoadjuvant therapy, 120mg each time, once every 2 weeks, for four times. During the period of RC48 therapy, two CTU reexamination showed the volume of tumor was significantly reduced, and the disease was effectively controlled. Three months after CABG, RC was performed. Postoperative pathological examination revealed high-grade muscle-invasive urothelial carcinoma of the bladder, T_2bN₀M₀, with negative surgical margins. As a conclusion, the neoadjuvant therapy with antibody-drug conjugations represented by RC48 shows a bright future, so it's worth further exploration.
- bladder cancer /
- neoadjuvant /
- RC 48 /
- antibody-drug conjugate

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图 1 患者CTU显示

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图 2 患者术后病理切片

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