case_images: PMC10919909_01
case_images: a Before nivolumab therapy, multiple liver metastases are apparent. b Two months after nivolumab therapy, the tumor has shrunk. c Nine months after nivolumab therapy, the tumor has shrunk further.
case_images: cro-2024-0017-0001-537779_F01.jpg
case_images: PMC10919909_01_cro-2024-0017-0001-537779_F01.jpg
case_images: F1
case_images: Liver metastases temporarily reduced in size, but the tumor enlarged again (Fig. 1a). Nivolumab (3 mg/kg every 2 weeks) was therefore started and the liver metastases displayed a reduction in size after 2 months (Fig. 1b). Administration of nivolumab was continued and the tumor shrank further (Fig. 1c), but the patient suffered from general malaise.
case_images: a At the discontinuation of nivolumab therapy, the tumor remains in a shrunken state, but infiltrative shadows are seen in the lung fields. b Five months after discontinuation of nivolumab therapy, the tumor has shrunk further. Infiltrative shadows in the lung fields are reduced. c Nine months after discontinuation of nivolumab therapy, liver metastases have almost disappeared. Infiltrative shadows in the lung fields show further improvement.
case_images: cro-2024-0017-0001-537779_F02.jpg
case_images: PMC10919909_01_cro-2024-0017-0001-537779_F02.jpg
case_images: F2
case_images: After 28 months of nivolumab administration, the patient developed cough due to bronchitis and malaise had worsened, so nivolumab was discontinued (Fig. 2a). Moreover, the metastatic tumors shrank further after discontinuation of nivolumab (Fig. 2b). Nine months after discontinuation of nivolumab, CT showed that the liver metastases had almost disappeared (Fig. 2c).
case_images: Clinical course. EVAR: endovascular aneurysm repair; S-1 (120 mg/body; days 1-14 every 3 weeks); SOX: S-1 (120 mg/body; days 1-14 every 3 weeks) and oxaliplatin (80 mg/m2 every 3 weeks); RAM + PTX: ramucirumab (8 mg/kg; days 1, 15) and paclitaxel (80 mg/m2; days 1, 8, 15); CPT-11: irinotecan (140 mg/m2 every 2 weeks); DOC: docetaxel (50 mg/m2 every 3 weeks); nivolumab was started at 3 mg/kg every 2 weeks and the dose interval of nivolumab was gradually increased to every 4, 6, and 8 weeks; hydrocortisone was started at 15 mg and then tapered off.
case_images: cro-2024-0017-0001-537779_F03.jpg
case_images: PMC10919909_01_cro-2024-0017-0001-537779_F03.jpg
case_images: F3
case_images: Currently, as of 3.5 years after discontinuation of nivolumab and 8 years after recurrence of liver metastases, no radiological evidence of recurrence has been identified (Fig. 3).