International Cancer Conference Journal最新文献

{"title":"Successful treatment of primary intramedullary spinal cord lymphoma based on the molecular diagnosis of a MYD88 mutation in the cerebrospinal fluid: a case report.","authors":"Takuma Aoki, Makoto Ohno, Shunsuke Yanagisawa, Daisuke Kawauchi, Takaki Omura, Akiya Kawanishi, Mai Honda-Kitahara, Yoshitaka Narita","doi":"10.1007/s13691-025-00799-2","DOIUrl":"10.1007/s13691-025-00799-2","url":null,"abstract":"<p><p>Primary intramedullary spinal cord lymphoma (PISCL) is a rare subtype of primary central nervous system lymphoma (PCNSL) that mimics other myelopathies, often leading to delayed diagnosis. Histopathological confirmation via spinal biopsy is the gold standard; however, spinal biopsies carry considerable risks. The <i>myeloid differentiation primary response gene 88</i> (<i>MYD88</i>) L265P mutation is highly specific for PCNSL and can be detected in the cerebrospinal fluid (CSF) by liquid biopsies. However, the utility of detecting <i>MYD88</i> L265P mutation in diagnosing PISCL still remains unclear. A 76-year-old woman presented with progressive right leg weakness, sensory deficits, and bowel and bladder dysfunctions. Spinal magnetic resonance imaging (MRI) revealed an intramedullary lesion from C7 to T12. Although the elevated levels of interleukin-10 and soluble interleukin-2 receptor in the CSF were suggestive of a lymphoma, flow cytometry failed to provide a definitive diagnosis. The <i>MYD88</i> L265P mutation was detected in the CSF. PISCL was diagnosed based on the results of the liquid biopsy, which was performed instead of a spinal biopsy owing to the associated risks of the latter. Treatment with rituximab, high-dose methotrexate, and focal radiotherapy was initiated. Posttreatment MRI showed lesion size reduction, and the <i>MYD88</i> mutation was undetectable in the CSF. However, the patient's neurological deficits persisted despite tumor control, and she died 6 months later due to general clinical deterioration. Our case demonstrates that the detection of <i>MYD88</i> mutations in the CSF can serve as a noninvasive diagnostic tool for PISCL, enabling early treatment while avoiding the risks associated with spinal biopsies. Liquid biopsy of the CSF provides a promising alternative for diagnosing PISCL. However, further studies are needed to validate the clinical utility of this diagnostic approach.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"472-478"},"PeriodicalIF":0.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tirabrutinib rechallenge achieved complete response for recurrent primary central nervous system lymphoma: illustrative case.","authors":"Daisuke Kawauchi, Yasuji Miyakita, Yuki Kawaguchi, Makoto Ohno, Shunsuke Yanagisawa, Takaki Omura, Takuma Aoki, Yoshitaka Narita","doi":"10.1007/s13691-025-00797-4","DOIUrl":"10.1007/s13691-025-00797-4","url":null,"abstract":"<p><p>Primary central nervous system lymphoma (PCNSL) is an aggressive non-Hodgkin lymphoma with a poor prognosis, with a 5-year survival rate of 23-42%. Relapse occurs in 35-60% of patients within 1-2 years, and no standard treatment exists for recurrent PCNSL. Tirabrutinib, a second-generation BTK inhibitor, is used for recurrent PCNSL treatment in Japan, but its efficacy in rechallenge therapy remains uncertain. A 75-year-old man presented with gait disturbance, dysarthria, and ataxia. MRI revealed a contrast-enhancing lesion in the right cerebellar hemisphere, and a biopsy confirmed PCNSL. He achieved a complete response with rituximab and high-dose methotrexate, but recurrence occurred a year later in the left frontal lobe. Tirabrutinib induced remission for six months before a new recurrence in the right frontal lobe. After craniotomy with tumor biopsy reconfirmed PCNSL, he underwent rituximab, methotrexate, procarbazine, and vincristine followed by high-dose cytarabine, achieving remission. A third recurrence led to a tirabrutinib rechallenge, and remission lasted five months. He ultimately developed leptomeningeal disease and received best supportive care before passing away three months later. This case highlights the potential of tirabrutinib rechallenge in recurrent case of PCNSL. Further studies are necessary to evaluate its prognostic value in PCNSL management.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"358-364"},"PeriodicalIF":0.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance mechanism to pembrolizumab in <i>DEK</i>-<i>AFF2</i> fusion-associated sinonasal squamous cell carcinoma.","authors":"Shogen Boku, Takao Fujisawa, Shigenori Kadowaki, Hironaga Satake, Hisateru Yasui, Koushiro Ohtsubo, Yasushi Shimizu, Tomoyuki Otsuka, Bunya Kuze, Riu Yamashita, Taro Shibuki, Yoshiaki Nakamura, Hideaki Bando, Takayuki Yoshino, Milan Radovich, Susumu Okano","doi":"10.1007/s13691-025-00796-5","DOIUrl":"10.1007/s13691-025-00796-5","url":null,"abstract":"<p><p>Recently, the first case of a novel <i>DEK</i>-<i>AFF2</i> fusion has been identified in nonkeratinizing squamous cell carcinoma (SCC) of the sinonasal tract with an exceptional response to pembrolizumab. Here we present the case of a 71-year-old female with metastatic poorly differentiated SCC of the sinonasal cavity with a <i>DEK</i>-<i>AFF2</i> fusion. She initially received pembrolizumab monotherapy as first-line treatment, but the disease progressed after two months. Subsequent treatment with paclitaxel plus cetuximab also led to disease progression after two months. She was enrolled in the SCRUM-Japan MONSTAR-SCREEN-2, a nationwide molecular profiling project. Tumor tissue samples were analyzed using whole exome and transcriptome sequencing (WETS). WETS of a pretreatment tissue specimen revealed <i>DEK</i>-<i>AFF2</i> fusion and <i>APC</i> pathogenic variant (p.G1677fs), and HLA genotype HLA-A*02:06/24:02, HLA-B*39:04/54:01, and HLA-C*01:02/07:02. Third-line therapy with 5-FU, carboplatin, and pembrolizumab achieved a partial response, but disease progression occurred after nine months. In tissues obtained from pancreatic metastases, acquired amplification of <i>MYC</i> (copy number 8.7) was detected in addition to <i>DEK</i>-<i>AFF2</i> fusion and <i>APC</i> mutation. These findings suggest that the lack of benefit from pembrolizumab despite the presence of <i>DEK</i>-<i>AFF2</i> fusion may be due to the HLA haplotype being different from one reported to be associated with efficacy. Additionally, acquired <i>MYC</i> amplification may contribute to resistance to chemotherapy and pembrolizumab. These findings underscore the importance of personalized treatment strategies in SCC patients with specific genomic alterations.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"458-463"},"PeriodicalIF":0.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of primary ovarian clear cell carcinoma with <i>ETV6::NTRK3</i> fusion.","authors":"Daisuke Ochiai, Tatsuyuki Chiyoda, Kohei Nakamura, Reika Takamatsu, Mitsuyo Jisaka, Tomomi Sakamaki, Mio Takahashi, Yumiko Kimura, Shinya Oki, Tomoko Yoshihama, Kensuke Sakai, Hiroshi Nishihara, Wataru Yamagami","doi":"10.1007/s13691-025-00795-6","DOIUrl":"10.1007/s13691-025-00795-6","url":null,"abstract":"<p><p>We report the first documented case of primary ovarian clear cell carcinoma harboring an <i>ETV6::NTRK3</i> fusion gene. A 49-year-old woman presented with a rapidly growing ovarian cyst that was diagnosed as stage IC1 clear cell carcinoma following primary debulking surgery. Molecular analysis revealed an <i>ETV6::NTRK3</i> fusion gene, confirmed by RT-PCR and Sanger sequencing. The tumor also contained an <i>ARID1A</i> variant (p.P1326Rfs*155), exhibited low tumor mutation burden (3.7 Muts/Mbp), and showed stable microsatellite status. Following standard surgical and chemotherapeutic treatment, the patient remained disease-free at 2.5 years post-surgery. This case demonstrates that <i>NTRK</i> fusion gene, in conjunction with <i>ARID1A</i> mutation, may contribute to clear cell carcinoma development, highlighting the need for further investigation into the prevalence and significance of <i>NTRK</i> fusions in ovarian clear cell carcinomas. The identification of this actionable genetic alteration provides potential targeted therapeutic options should disease recurrence occur.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"453-457"},"PeriodicalIF":0.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative molecular analysis of primary and recurrent pleomorphic xanthoastrocytoma with BRAF mutation treated with combination therapy with dabrafenib and trametinib: a case report and literature review.","authors":"Shoto Tateoka, Takahiro Ono, Junta Moroi, Hajime Miyata, Takuya Furuta, Mayuko Moritsubo, Hiroshi Nanjo, Yoshitaka Narita, Hiroaki Shimizu","doi":"10.1007/s13691-025-00794-7","DOIUrl":"10.1007/s13691-025-00794-7","url":null,"abstract":"<p><p>The role of chemotherapy in pleomorphic xanthoastrocytomas (PXA) remains unclear. Although molecular targeted therapy against the driver gene <i>BRAF</i> has been recently explored, evidence of its efficacy and post-treatment course is limited. Here, we present a case of grade 3 PXA that exhibited malignant progression following transient remission with <i>BRAF</i>-targeted therapy, accompanied by the emergence of multiple genetic alterations. A 22-year-old woman presented with a sudden headache and was diagnosed with a hemorrhagic lesion infiltrating the right temporal lobe and insula. Subtotal resection revealed grade 3 PXA. Conventional radiotherapy combined with temozolomide proved ineffective. After multigene panel testing (MGPT) identified <i>BRAF</i> V600E mutation, the patient underwent combination therapy with dabrafenib and trametinib. Although the residual tumor initially shrank significantly, recurrence occurred 16 months later. Despite salvage surgery and continued <i>BRAF</i>-targeted therapy, the tumor progressed, and the patient passed away 25 months after diagnosis. In-house MGPT of the recurrent tumor revealed <i>BRAF</i> amplification and other multiple abnormalities in the MAPK, TP53, RB, and mismatch repair pathways. This is the first reported case of multi-oncogenic pathway alterations following <i>BRAF</i>-targeted therapy in PXA. These genetic abnormalities likely contributed to the tumor's drug resistance and aggressive progression in this case.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"365-373"},"PeriodicalIF":0.4,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early detection of drug-induced interstitial lung disease using an electronic patient-reported outcome system: a report of two cases.","authors":"Yuki Takei, Akiko Matsumoto, Atsuhumi Nomoto, Mizuki Kawashima, Yuko Miyake, Arisa Kawakami, Tadamitsu Shima, Isao Teshima, Natsumi Nomoto, Yoshiharu Mitsunaga, Tamaki Watanabe, Yukie Nagase, Nobuhiro Yasuno, Hiromitsu Jinno","doi":"10.1007/s13691-025-00792-9","DOIUrl":"10.1007/s13691-025-00792-9","url":null,"abstract":"<p><p>Drug-induced interstitial lung disease (DILD) is an adverse event associated with the use of various anticancer drugs. Although DILD is rare, it is a serious complication that can lead to treatment interruption and, in some cases, life-threatening outcomes. The early detection of DILD requires careful monitoring of subjective symptoms, regular computed tomography (CT) scans, and biomarker assessments. We present two cases in which electronic patient-reported monitoring by a pharmacist, utilizing an electronic patient-reported outcome (ePRO) application, enabled the early detection of DILD in patients with breast cancer undergoing anthracycline-based adjuvant therapy and treatment for recurrence with everolimus (EVL) and exemestane (EXE). In the first case, a woman in her 50 s with early stage breast cancer received dose-dense epirubicin and cyclophosphamide (EC) therapy as adjuvant treatment following surgery. On day 14 of the second cycle, the ePRO flagged cough and fever symptoms. The following day, the patient's fever subsided, and chest X-rays showed no abnormal findings. The third cycle of dose-dense EC therapy was discontinued, and the patient was followed up. Monitoring with ePROs was continued, and on day 18, the patient developed a fever again and experienced worsening dyspnea, prompting a medical consultation. Chest CT confirmed the diagnosis of DILD, and steroid pulse therapy was initiated. In the second case, a woman in her 60 s with recurrent breast cancer underwent EVL + EXE. Between days 86 and 89, ePROs identified fever, fatigue, and cough, prompting the patient to consult a physician. A chest CT scan revealed grade 1 DILD, which led to the discontinuation of EVL therapy. These cases suggest that the application of ePRO is valuable for the early detection of DILD, potentially improving patient outcomes by allowing timely intervention.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"433-439"},"PeriodicalIF":0.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atezolizumab-induced myasthenia gravis and myositis: a fatal case report and review of the literature.","authors":"Yuya Kobayashi, Kiyoshiro Nagamatsu, Yusaku Shimizu, Ataru Nakayama, Yoshiki Sekijima","doi":"10.1007/s13691-025-00791-w","DOIUrl":"10.1007/s13691-025-00791-w","url":null,"abstract":"<p><p>Immune checkpoint inhibitors can cause immune-related adverse events, with neurologic manifestations such as myasthenia gravis (MG) and myositis predominantly reported with PD-1 inhibitors, while cases linked to PD-L1 inhibitors remain rare. An 84-year-old man with hepatocellular carcinoma developed severe MG and myositis after atezolizumab treatment. Despite intensive therapy, including corticosteroids, plasma exchange, and intravenous immunoglobulin, his condition worsened, and he died. MG in cancer patients poses treatment challenges due to tumor progression and functional decline. Given the limited reports on atezolizumab-induced MG, further case accumulation is essential to improve understanding of its clinical course and optimize management strategies.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"428-432"},"PeriodicalIF":0.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary ALK-negative ALCL of the small intestine: a rare case report with review of literature.","authors":"Tanisha Singla, Nilay Nishith, Rahul Raj, Aishwarya Sharma, Puneet Kaur Somal, Ravikiran Pawar, Sankalp Sancheti, Simran Kalra","doi":"10.1007/s13691-025-00787-6","DOIUrl":"10.1007/s13691-025-00787-6","url":null,"abstract":"<p><p>ALK-negative primary anaplastic large cell lymphoma (ALCL) of the small intestine is exceptionally rare and presents significant diagnostic and therapeutic challenges. Characterized by large-sized neoplastic lymphoid cells with scant cytoplasm and pleomorphic nuclei, its clinical presentation is often nonspecific, mimicking infections or inflammatory disorders. We present a rare case of ALK-negative primary ALCL of the small intestine in a 35-year-old male who presented with fever, abdominal pain, and significant weight loss. This case highlights the need for heightened clinical suspicion, a comprehensive histopathological and immunophenotypic approach, and optimal management strategies for this aggressive entity.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"412-420"},"PeriodicalIF":0.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transanal minimally invasive surgery for rectal gastrointestinal stromal tumor using articulated forceps after neoadjuvant chemotherapy with imatinib mesylate.","authors":"Hideyuki Masui, Yoshiro Itatani, Ryosuke Okamura, Michio Okamoto, Atsushi Yamada, Yusuke Sakamoto, Nobuaki Hoshino, Koya Hida, Kazutaka Obama","doi":"10.1007/s13691-025-00786-7","DOIUrl":"10.1007/s13691-025-00786-7","url":null,"abstract":"<p><p>Rectal gastrointestinal stromal tumors (GISTs) are rare, accounting for approximately 5% of all GISTs and 0.1% of all rectal malignancies. Radical resection without capsule violation is the standard treatment for localized GISTs. However, surgical resection of large rectal GISTs poses challenges because of the narrow pelvic anatomy and the need to preserve excretory function. Based on KIT mutation status, neoadjuvant imatinib therapy facilitates tumor shrinkage and improves surgical outcomes. A 72-year-old man presented with dyschezia and hematochezia. Colonoscopy revealed a submucosal rectal tumor measuring 3 cm from the anal verge, which was diagnosed as a GIST based on biopsy findings (c-kit and DOG1 positive). Imaging studies confirmed the presence of a 5-cm tumor with significant ¹⁸F-FDG uptake. KIT mutation analysis revealed a rare exon 13 K642E mutation associated with imatinib sensitivity. Neoadjuvant imatinib therapy was administered for four months, which led to tumor shrinkage to 2.5 cm in diameter. Transanal minimally invasive surgery (TAMIS) was performed with curative intent, utilizing ArtiSential articulated forceps. Full-thickness resection was achieved without capsule violation. The patient had no postoperative complications and had retained full anal function. This case highlights the utility of a multimodal approach combining neoadjuvant imatinib therapy and TAMIS to manage large rectal GISTs. TAMIS facilitated complete tumor removal while preserving excretory function and avoiding extensive surgeries, such as total mesorectal excision. Notably, this is the first report of ArtiSential articulated forceps utilized in TAMIS, demonstrating their innovative potential in enhancing surgical precision and outcomes in challenging pelvic procedures.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13691-025-00786-7.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"401-406"},"PeriodicalIF":0.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathologic complete response to enfortumab vedotin plus pembrolizumab in node-positive urothelial carcinoma: a case report.","authors":"Takuto Hara, Eiki Inoue, Naoto Wakita, Takaaki Nakanishi, Kotaro Suzuki, Naoki Matsuyama, Taisuke Tobe, Hideto Ueki, Koji Chiba, Jun Teishima, Hideaki Miyake","doi":"10.1007/s13691-025-00785-8","DOIUrl":"10.1007/s13691-025-00785-8","url":null,"abstract":"<p><p>Patients with advanced nodal involvement (cN2 or cN3) in urothelial carcinoma (UC) typically have poor outcomes after radical surgery. Clinical evidence on how to manage these patients following immunotherapy is limited. Major neoadjuvant trials such as KEYNOTE-B15 and NIAGARA excluded patients with multiple or bulky nodal metastases, leaving a significant gap in evidence. We present a case of a 76-year-old man with cT1 bladder cancer, concomitant distal ureteral UC (≤ cT2), and multiple enlarged right pelvic lymph nodes (cN2). After six cycles of enfortumab vedotin plus pembrolizumab (EVP), he achieved a radiologic complete response (CR) and resolution of hydronephrosis. He then underwent robot-assisted right nephroureterectomy with extended pelvic lymph node dissection using the da Vinci Xi surgical system. Pathology revealed no residual cancer in either the primary site or lymph nodes (ypT0, ypN0), with marked fibrosis suggesting a strong treatment response. There were no surgical complications, and systemic therapy was stopped after surgery. To our knowledge, this is the first reported case of pathologic complete response following EVP and robotic nephroureterectomy in a patient with node-positive UC. This case supports the potential role of surgery in select patients with excellent responses to systemic therapy who were initially considered unresectable.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13691-025-00785-8.</p>","PeriodicalId":13703,"journal":{"name":"International Cancer Conference Journal","volume":"14 4","pages":"407-411"},"PeriodicalIF":0.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12696204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}