Ipilimumab/nivolumab

Abstract

Lack of efficacy: case report A 42-year-old man exhibited lack of efficacy during treatment with ipilimumab and nivolumab for stage IV small cell neuroendocrine cancer of prostate gland with osseous metastasis [routes and dosages stated]. The man presented with urinary frequency and haematospermia. He was subsequently diagnosed with stage IV small cell neuroendocrine cancer of prostate gland with osseous metastasis. He initially received cisplatin and etoposide for treatment, and then he was treated with topotecan. However, he developed disease progression. Therefore, he started receiving the combination of ipilimumab and nivolumab. However, the combination was discontinued after 5 months due to lack of response. After two months, he received radiation therapy to the lower pelvis and prostate, and palliative radiation therapy to the left femur. He subsequently underwent multiple lines of treatment without satisfactory response. Follow up imaging test showed new lung and liver lesions, which was indicative of disease progression. Thereafter, his treatment was switched to atezolizumab and paclitaxel [nab-paclitaxel] combination. He was also concurrently receiving stereotactic ablative radiotherapy to pelvic region, paraspinal region and paraaortic lymphnodes. Repeated imaging test after two months of the treatment showed an increase in pulmonary nodule size. His treatment was continued for progressive disease. Repeat CT-scan after 6 weeks showed resolution of metastatic liver lesions and improvement of lung lesions.