Positive case studies

[TomsD1]

Literature trawl - copy the text and paste into Google search to find papers. This is just the best bits. Jo

9 yearWe present a case of a patient with castration-resistant prostate cancer with proven bone lesions 2 years after the onset of the disease and the current survival of over 9 years.

In 2013, a significant increase in PSA was reported, studied castration serum testosterone levels (below 10 ng/ml). Maximum androgen blockade was performed with a steroid aromatase inhibitor (Cyproterone acetate) and an LHRH analog (Suprefact depo). In January 2014, zoledronic acid therapy was discontinued due to osteonecrosis of the mandible. CT of the chest, abdomen, and pelvis (April 2014) describes new bone lesions. According to the decision of the Medical Oncology Board from 06.2014, treatment with Denosumab, Abiraterone acetate, and Prednisone was started. From the restaging imaging, stable disease is reported (Fig. 2).

Fig. 2

Fig. 2

Dynamics of PSA level.

In October 2020, the patient discontinued treatment due to COVID-19 infection with bilateral pneumonia. When restoring January 2021, only mild anemia was demonstrated without evidence of new disease progression. The patient, already 87 years old, continues hormone therapy and monoclonal antibody for bone disease with a good quality of life.

Five plus years.

Here, is presented the case of a metastatic CRPC patient affected by few and oligosymptomatic bone metastases, with an exceptional and durable response after 5 years from the starting of Ra-223 therapy and a concomitant suspension of ADT. The patient is still clinically asymptomatic with a persistent radiological response and undetectable PSA (Prostate specific antigen) levels.

Immunotherapy

Here, we report on two patients who received ipilimumab in these trials and are still in long-term complete remission with a follow-up of 64 and 52 months respectively after the initiation of ipilimumab. Immunohistochemical staining for hMLH1, hMSH2, hMSH6 and PMS2 was performed on archival prostate biopsy samples from one of the two patients; they exhibited normal protein expression. Interestingly for this patient, a high CD3+ and CD8+ T cell infiltration was observed on archival prostate biopsies as well as Treg FoxP3+ T cells.