PMC10083011_01
Objective response after CD137 agonist treatment. A baseline CT scan (A and B) detected left external iliac (A; white star) and popliteal metastatic lymph nodes (B; white arrow), which completely disappeared (C, black star; D, black arrow) after 6 months from the last dose of therapy.
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Despite early treatment discontinuation, the patient achieved complete response (CR) in May 2009, 6 months after the last dose of urelumab, as shown by a CT scan (Figure 1).
Mixed response after third line-therapy with ipilimumab. A baseline FDG-PET scan revealed progression of disease (A; black arrows), with evidence of a right inguinal lymph node (B; white star) and a left thigh subcutaneous lesion (C; white arrow). Tumor assessment performed at week 12 with FDG-PET scan showed a mixed response (D; black arrows), due to the regression of nodal disease (E; grey star) and the worsening of subcutaneous lesion (F; grey arrow).
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Tumor assessment (TA) performed by FDG-PET scan at week 12 showed a mixed response consisting of a partial regression of the right inguinal node and a progression of the left thigh subcutaneous lesion. Thus, the patient had achieved stable disease (SD) as per immune-related Response Criteria (irRC) and PD as per Response Evaluation Criteria in Solid Tumors (RECIST) v. 1.1 (Figure 2).
Complete metabolic response after fourth-line therapy with pembrolizumab. A baseline FDG-PET scan showed a left thigh subcutaneous lesion (A and B; black arrows), completely disappeared at week 24 (C and D; grey arrows).
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Based on the confirmed PD, in October 2014 the patient received fourth-line therapy with the anti-PD-1 pembrolizumab (2 mgs) i.v. every 3 weeks within an EAP, achieving a new CR at week 24 of therapy (Figure 3).