International Cancer Conference Journal最新文献

Melanoma originating from the genitourinary tract is very rare and accounts for less than 1% of all melanomas. Among the primary melanoma of the genitourinary tract, the bladder forms the most common anatomical location, followed by the adrenal gland, kidney, female urethra, and penis. Primary prostatic melanoma is a rare condition and poses a diagnostic challenge. We present a case report of primary prostatic melanoma in an elderly individual who presented with symptoms from a local extension of the disease.

Anaplastic lymphoma kinase (ALK)-positive histiocytosis is a recently classified rare subtype of histiocytic neoplasm, characterized by ALK immunoreactivity due to ALK gene rearrangement. Most reported cases have developed in infants and middle-aged individuals, with effective ALK inhibition. The clinicopathological spectrum remains uncharacterized because of few reported cases. Herein, we report a case of a 70-year-old woman diagnosed with ALK-positive histiocytosis involving the nervous system, successfully treated with partial surgical resection and alectinib administration. To the best of our knowledge, this is the oldest patient reported with this condition with nervous system involvement, expanding our understanding of its clinicopathological spectrum.

We report a case of a 60-year-old female diagnosed with epidermal growth factor receptor (EGFR) exon 19-mutant non-small cell lung cancer (NSCLC). She developed leptomeningeal disease (LMD) about 2 years after her initial cancer diagnosis and experienced multiple subsequent relapses of her leptomeningeal carcinomatosis with parenchymal brain metastases. She currently is alive with excellent performance status at 82 months since the LMD diagnosis. Treatment has consisted of different conventional and experimental EGFR targeted therapies along with intrathecal chemotherapy. This report, to the best of our knowledge, represents the longest overall survival (OS) of LMD reported in patients with EGFR-mutant NSCLC and suggests that leveraging different mechanisms of action to target EGFR mutation in a sequential fashion with multidisciplinary teams' involvement can potentially help control the LMD and prolong the OS in this patient population.

This study evaluates the efficacy and tolerability of low-dose oral cyclophosphamide, with or without bevacizumab, in treating recurrent ovarian and cervical cancer among patients heavily pretreated with platinum-based chemotherapy. It presents case reports of individuals who received low-dose cyclophosphamide (50 mg/day) and bevacizumab (15 mg/kg per cycle for three to four weeks) in a metronomic treatment approach. Focusing on three significant cases from a cohort of eleven treated with these regimens, the case report demonstrates partial responses, delayed disease progression, and minimal adverse effects. These findings highlight the regimen's potential to maintain quality of life and performance status. The study underscores the therapeutic benefits and mild toxicity profile of low-dose cyclophosphamide with or without bevacizumab, suggesting its potential as a viable treatment option for patients with extensive treatment history. This regimen is particularly promising in settings prioritizing quality of life.

A 53-year-old man with a tumorous lesion at the bladder apex was diagnosed with an unresectable urachal carcinoma. After 10 cycles of combined therapy with 5-fluorouracil, leucovorin, and oxaliplatin, a combination of trifluridine/tipiracil and bevacizumab was initiated as second-line chemotherapy. Despite requiring a switch to bevacizumab monotherapy after the sixth cycle due to hematological toxicity, this regimen effectively controlled the disease for 16 cycles. It resulted in a progression-free survival of 17 months. To the best of our knowledge, this is the first report documenting the use of trifluridine/tipiracil and bevacizumab combination therapy for urachal carcinoma. While the observed disease control was notable in this patient, further accumulation of clinical experience and careful evaluation are warranted before generalizing the efficacy of this regimen in this rare malignancy.

A 51-year-old woman with a 54-month history of treatment with bone-modifying agents for thyroid cancer bone metastases, namely zoledronic acid for three months and denosumab for 51 months, presented with jaw pain, trismus, and ear discharge. Physical examination, bacterial culture, and radiological findings led to a diagnosis of osteonecrosis of the external auditory canal. Since the discontinuation of denosumab did not improve the diagnosed condition, she underwent surgical reconstruction. Bone-modifying agents such as zoledronic acid and denosumab, which are commonly used to prevent skeletal-related events in patients with bone metastases from various cancers, have been used for several years, especially for patients with slow-growing cancers. Osteonecrosis of the external auditory canal is an infrequent but serious adverse event caused by prolonged use of bone-modifying agents. Therefore, clinicians should be fully aware of its potential risks in the long-term management of bone metastasis.

Clinical evidence supporting the use of PD-1/PD-L1 inhibitors in treating urothelial carcinoma with microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) remains limited. We report a case of 77-year-old male with a history of multiple cancers. Immunohistochemical staining of bladder tumor revealed the loss of MSH2 and MSH6 expression, and MSI-H by PCR-based method and pathogenic alterations in MSH2 and MSH6 genes by next generation sequencing were confirmed, suggesting Lynch syndrome. He received pembrolizumab for local recurrence after total pelvic exenteration and recurrent upper tract urothelial carcinoma, and achieved complete remission. This case supports the potential of PD-1/PD-L1 inhibitors as a promising treatment option for MSI-H or dMMR urothelial carcinoma, similar to other solid tumors with MSI-H or dMMR.

Primary carcinosarcomas are a rare type of cervical tumors. A 75-year-old female patient diagnosed with stage IB2 cervical carcinosarcoma (CCS) was treated with radical surgery followed by adjuvant chemoradiotherapy. She survived without recurrence for 3 years after the surgery. Double somatic mutations of the ATM (c.802C > T [p.Glu268*], variant allele frequency [VAF] of 48.5%, and c.7181C > T [p.Ser2394Leu], VAF of 45.1%) and NF2 (c.1021C > T [p.Arg341*], VAF of 2.4%) genes were detected in the CCS via next-generation sequencing analyses. Retrospective studies using large databases should be performed to establish a consensus regarding the use of combination therapies in elderly patients with primary CCS. To the best of our knowledge, this report first revealed the presence of ATM mutations in a patient with primary CCS. Previous studies and the current data showed therapeutic possibilities for the subsets of gynecologic carcinosarcoma and provided information on the molecular mechanism of its development.

A 65-year-old man presented with dysphagia and was diagnosed with advanced thoracic esophageal squamous cell carcinoma (ESCC, cStage III, cT3N2M0). Initial treatment included three courses of preoperative chemotherapy with the DCF regimen. However, computed tomography (CT) showed tumor progression, leading to esophageal obstruction at the level of the tracheal bifurcation. The patient subsequently underwent chemoradiotherapy (CRT) combining the DCF regimen with radiotherapy (59.4 Gy). While CRT resulted in tumor shrinkage and reduced lymph node metastasis, residual target lesions persisted. As second-line therapy, nivolumab (240 mg/body, biweekly) was initiated. The treatment was well tolerated, with no significant adverse events. After 36 courses of nivolumab, complete response (CR) of both the primary tumor and metastatic lymph nodes was confirmed through CT, PET-CT, and upper gastrointestinal endoscopy. The patient has remained recurrence-free, with no evidence of new metastasis, and continues to maintain favorable clinical progress. A literature review identified only eight cases of CR achieved with nivolumab for advanced esophageal cancer, with only two involving ESCC, both in cases of recurrence after surgery or CRT. This is the first reported case of CR achieved with nivolumab in unresectable advanced ESCC. Despite PD-L1 expression being below 1%, nivolumab elicited a robust antitumor immune response. This case highlights the potential of immunotherapy, even in cases with low PD-L1 expression, for advanced ESCC.

Retroperitoneal sarcoma (RPS) is a biologically heterogeneous tumor and rare malignant mesenchymal soft-tissue neoplasm. Although the 5-year overall survival rate for RPS is approximately 60%-70%, it is quite low for unresectable tumors. Surgery is a standard treatment for RPS. Immune checkpoint inhibitors (ICIs) have shown promising effects against various tumor types; however, the efficacy of ICIs for RPS is unclear and the combination of ICIs with other drugs or treatments has been considered. We report the case of a 71-year-old woman with dual primary cancer, retroperitoneal leiomyosarcoma, and malignant melanoma in the lower leg. Retroperitoneal leiomyosarcoma was considered inoperable and managed with palliative radiotherapy. However, subsequent treatment with nivolumab for melanoma resulted in significant shrinkage of the retroperitoneal leiomyosarcoma. The genomic analysis revealed a low TMB and poor CD8 score. These findings suggest that the retroperitoneal leiomyosarcoma would be immunologically cold. We report an unexpectedly successful treatment of RPS with ICI therapy after radiotherapy. There have been few reports on the detailed genetic profiles of sarcomas that respond to ICI therapy. Our findings suggest that the combination of radiotherapy and ICIs has therapeutic potential for immunologically cold tumors and may be a useful treatment strategy for RPS.

Supplementary information: The online version contains supplementary material available at 10.1007/s13691-025-00771-0.