PMC5174801_01
Axial baseline CT scan: large bulky peritoneal tumor mass with about 11x11x14 cm holding in size.
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September 2015. Suspected disease progression was confirmed when she was restaged, showing a large unresectable bulky peritoneal metastasis with about 11x11x14 cm holding in size (baseline size 11x11x14 cm, see figures 1 and 2).
Coronal baseline CT scan: large bulky peritoneal tumor mass with about 11x11x14 cm holding in size.
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September 2015. Suspected disease progression was confirmed when she was restaged, showing a large unresectable bulky peritoneal metastasis with about 11x11x14 cm holding in size (baseline size 11x11x14 cm, see figures 1 and 2).
Invasion front (pushing margin) of the patient's tumour from the primary resection showing a high number of tumour-infiltrating leucocytes, which is characteristic for mismatch-repair-deficient (MMR) tumours.
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In retrospect, the tumour showed a characteristic histological picture of a high number of tumour-infiltrating lymphocytes (see figure 3).
Axial CT scan after six cycles of pembrolizumab shows a partial remission of the peritoneal tumour mass to 25% of the original tumour volume (6.2x7.1x10.4 cm).
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At the end of December, a CT scan showed an impressive response with shrinkage of the peritoneal tumour mass to 25% of the original tumour volume (6.2x7.1x10.4 cm, see figures 4 and 5).
Coronal CT scan after six cycles of pembrolizumab shows a partial remission of the peritoneal tumour mass to 25% of the original tumour volume (6.2x7.1x10.4 cm).
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At the end of December, a CT scan showed an impressive response with shrinkage of the peritoneal tumour mass to 25% of the original tumour volume (6.2x7.1x10.4 cm, see figures 4 and 5).
Axial CT scan after 11 cycles of pembrolizumab shows a further regression of the tumour mass to 5.5x7.0x8.0 cm.
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Tumour markers CEA and CA 19-9 and LDH levels decreased to normal levels, haemoglobin level increased from 8 to 13 mg/dL and her overall clinical performance status increased from ECOG 3 to 1 within 3 months (see figures 6-8).
Coronal CT scan after 11 cycles of pembrolizumab shows a further regression of the tumour mass to 5.5x7.0x8.0 cm.
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Tumour markers CEA and CA 19-9 and LDH levels decreased to normal levels, haemoglobin level increased from 8 to 13 mg/dL and her overall clinical performance status increased from ECOG 3 to 1 within 3 months (see figures 6-8).
Kinetics of serum tumor marker concentrations CEA and CA 19-9: from initiation of therapy in September 2015 to completion of 11 cycles pembrolizumab in late March 2016.
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Tumour markers CEA and CA 19-9 and LDH levels decreased to normal levels, haemoglobin level increased from 8 to 13 mg/dL and her overall clinical performance status increased from ECOG 3 to 1 within 3 months (see figures 6-8).
Lactate dehydrogenase (LDH) kinetics: from initiation of therapy in September 2015 to completion of 11 cycles pembrolizumab in late of March 2016.
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Restaging after 11 cycles of pembrolizumab showed further downsizing of the tumour mass (5.5x7.0x8.0 cm, see figures 9 and 10).
Steady rise in hemoglobin concentration: from initiation of therapy in September 2015 to completion of 11 cycles pembrolizumab in late of March 2016.
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Restaging after 11 cycles of pembrolizumab showed further downsizing of the tumour mass (5.5x7.0x8.0 cm, see figures 9 and 10).