PT  - JOURNAL ARTICLE
AU  - NAGAHISA, CHIKA
AU  - IIZUKA, JUNPEI
AU  - KOBARI, YUKI
AU  - MINODA, RYO
AU  - FUKUDA, HIRONORI
AU  - YOSHIDA, KAZUHIKO
AU  - OKUDA, HISASHI
AU  - ISHIDA, HIDEKI
AU  - NAGASHIMA, YOJI
AU  - TAKAGI, TOSHIO
TI  - Efficacy of Combined Pembrolizumab and Pelvic Radiotherapy for Bladder Cancer With Rectal Metastases
AID  - 10.21873/invivo.13162
DP  - 2023 Mar 01
TA  - In Vivo
PG  - 912--915
VI  - 37
IP  - 2
4099  - http://iv.iiarjournals.org/content/37/2/912.short
4100  - http://iv.iiarjournals.org/content/37/2/912.full
SO  - In Vivo2023 Mar 01; 37
AB  - Background/Aim: Rectal metastases from urothelial carcinoma (UC) are extremely rare with poor prognosis when treated with gemcitabine and cisplatin (GC) chemotherapy, radiation therapy, and total pelvic exenteration. Long-term survival has not been observed in patients treated with GC chemotherapy, radiation therapy, or total pelvic resection. However, there have been no reports on the efficacy of pembrolizumab therapy for this specific condition. Herein, we describe a case of rectal metastasis from UC, treated with combined pembrolizumab and pelvic radiotherapy. Case Report: A 67-year-old male patient with an invasive bladder tumour underwent robot-assisted radical cystectomy and ileal conduit diversion followed by neoadjuvant GC chemotherapy. The pathological findings showed high-grade UC, pT4a, with a negative surgical margin. He presented with an impacted ileus due to severe rectal stenosis on postoperative day 35 and underwent a colostomy. Pathologically, rectal biopsy confirmed rectal metastasis; thus, the patient was started on pembrolizumab 200 mg every 3 weeks and pelvic radiotherapy with a total dose of 45 Gy. The rectal metastases remained well controlled with stable disease status, and no adverse events were observed 10 months after the initiation of combined pembrolizumab and pelvic radiotherapy. Conclusion: Pembrolizumab combined with radiation therapy may be an alternative treatment for rectal metastases from UC.