PMC7399050_01
Computed tomography of the ovary before and after initiation of nivolumab treatment. (A) Tumor status before treatment, (B) Pseudo-progression within the first 2 months of treatment, (C) Partial response after treatment, (D) Progression.
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F1
Within the first 2 months of treatment, computed tomography (CT) results showed that the tumor size was increased from 57.67 x 43.51 to 71.30 x 50.62 mm (Figures 1A,B) and an unconfirmed progression was observed according to Immune Response Evaluation Criteria in Solid Tumors (iRECIST) criteria. It was concluded that the patient reached a partial response (PR) (Figure 1C). The CA-125 remained plateau during the treatment and increased on June 21st (Figure 3), in accordance with the increase of tumor size in the CT results (Figure 1D).
Course of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum in relation to applied therapies; course of biochemical markers over time.
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F2
Alanine aminotransferase (ALT) and Aspartate aminotransmerase (AST) (Figure 2), which was diagnosed as the immune-related hepatitis according to CTCAE grading system. According to literature research showing the association between irAEs and efficacy, the presence of liver irAE might suggest that the patient might be benefiting from immunotherapy even though the tumor was enlarged. The ALT and AST gradually returned to normal (Figure 2).
Course of cancer antigen 125 (CA-125) levels in relation to applied therapies; course of tumor markers over time. Arrows indicate application of nivolumab therapy.
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F3
Also the tumor biomarker cancer antigen 125 (CA-125) dropped from 103.1 to 50.2 U/mL (Figure 3). The CA-125 remained plateau during the treatment and increased on June 21st (Figure 3), in accordance with the increase of tumor size in the CT results (Figure 1D).