[A Case of Remarkable Immune-Cell Therapy Efficacy in a Patient with Renal Pelvic Cancer Refractory to Immune Checkpoint Inhibitors and Chemotherapy].

Abstract

A 70s-year-old woman with a history of Lynch syndrome had ovarian, colon, and right renal pelvic cancers, all of which were detected early and surgically treated with no recurrence. Ten years have passed since the most recent surgical procedure. In September 2020, she developed hematuria and underwent an examination, which revealed left renal pelvic cancer with liver and lung metastases. Chemotherapy(GEM+CBDCA)was initiated in October 2020; however, imaging in April 2021 revealed disease progression. Treatment with an immune checkpoint inhibitor(ICI: pembrolizumab 240 mg/body)was initiated, but after 4 months, the disease progressed and the treatment was discontinued. The patient was then referred to our hospital. Immunological testing revealed a decrease in T cells; therefore, immune-cell therapy(αβT cell therapy)was initiated to improve this condition. After 4 sessions of αβT cell therapy at 2-week intervals, a CT scan in November 2021 revealed shrinkage of the liver metastases and renal pelvis tumor, and the patient was assessed as having a partial response. By February 2022, after a total of 7 sessions of αβT cell therapy, further tumor shrinkage was observed, and the tumor was almost completely resolved on imaging. Although further immunotherapy is rarely administered in patients for whom ICI is ineffective, our findings suggest the potential for significant immune-cell therapy efficacy even after ICI failure.