Durable disease control after multimodal therapy and platinum-based chemotherapy rechallenge in advanced clear cell adenocarcinoma of the urethra with lymph node metastases: a case report - Scorecard - MDSpire
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Durable disease control after multimodal therapy and platinum-based chemotherapy rechallenge in advanced clear cell adenocarcinoma of the urethra with lymph node metastases: a case report
Clinical Scorecard: Sustained Disease Management Following Multimodal Treatment and Platinum-Based Chemotherapy Rechallenge in Advanced Clear Cell Adenocarcinoma of the Urethra with Lymph Node Involvement: A Case Study
At a Glance
Category
Detail
Condition
Clear Cell Adenocarcinoma of the Urethra (CCAU)
Key Mechanisms
Multimodal treatment including neoadjuvant chemotherapy, radical surgical resection, and chemotherapy rechallenge.
Target Population
Patients with advanced CCAU and lymph node metastasis.
Care Setting
Oncology and surgical management in a hospital setting.
Key Highlights
CCAU is an extremely rare subtype of primary urethral carcinoma.
Neoadjuvant gemcitabine plus cisplatin chemotherapy achieved a partial response.
Radical cystourethrectomy and pelvic lymph node dissection were performed with negative surgical margins.
Adjuvant nivolumab was discontinued due to immune-related hypothyroidism and nodal recurrence.
Chemotherapy rechallenge with GC led to another partial response.
Guideline-Based Recommendations
Diagnosis
Diagnosis based on imaging and pathological findings.
Management
Multimodal treatment including neoadjuvant chemotherapy, radical surgery, and chemotherapy rechallenge.
Monitoring & Follow-up
Radiologic response assessed via CT scans according to RECIST version 1.1.
Risks
Potential for immune-related adverse effects from nivolumab.
Patient & Prescribing Data
A 60-year-old woman with advanced CCAU and lymph node metastases.
Treatment included neoadjuvant GC chemotherapy, radical surgery, and subsequent chemotherapy rechallenge.
Clinical Best Practices
Consider multimodal treatment for advanced CCAU.
Monitor for immune-related adverse effects during immunotherapy.
Utilize genomic profiling to inform treatment strategies when applicable.
