2 CASE REPORT
A 56-year-old female was diagnosed with uterine endometrioid
adenocarcinoma stage I2b in April, 2020. She underwent a simple
hysterectomy, bilateral salpingo-oophorectomy,
greater
omentum segmental
resection, lymphadenectomy of pelvis, paraaortic, and retroperitoneum.
She strongly rejected the standard chemotherapy. We found that her CTC
level was high (6.2 cells/6.5 mL by Oncocount RGCC, Research Genetics
Cancer Center (RGCC) International GmBH, Switzerland). Pathological
tests revealed her CTC to be sensitive to chemotherapeutic agents, i.e.,
carboplatin and docetaxel, and MSI-high. However, she also rejected
treatment with immune-checkpoint inhibitors. Then, we found multiple
metastases in both sides of her lungs by computed tomography (CT) (Fig.
1, a-g, series i) and a positive signal in paraaortic lymph nodes on the
hilum of left kidney by positron emission tomography (PET)-CT (Fig. 1,
h, i) in October, 2020.
We therefore selected AFTV treatment. From November, 2020, to January,
2021, she was treated with three intradermal injections of AFTV, each of
them two weeks apart. AFTV was made from the patient’s own resected,
formalin-fixed uterine carcinoma tissue, similar to the procedure
reported in cases of glioblastoma.1 No problematic
adverse event has been observed (erythema and induration at the
injection sites, all less than CTCAE grade 2). Subsequently, we found by
CT imaging apparently reduced, almost faint, nine lung metastases in
December, 2021, as shown in Fig. 1, a-g, series ii. Especially, the lung
metastasis observed in Fig. 1, g, i (arrowhead with asterisk) had
disappeared in Fig. 1, g, ii, suggesting that AFTV monotherapy was
effective towards the lung metastases.
To our surprise, however, she was unwillingly guided towards the
standard chemotherapy at a regional big hospital in order to suppress
the remaining metastases. Reluctantly, she received one dosis of
chemotherapy with carboplatin and docetaxel (70 mg/m2and AUC 5, respectively) that resulted in several typical, severe
adverse effects such as nausea, diarrhea, stomatitis, anorexia,
numbness, psilosis, and transient leukopenia. She quickly rejected
further chemotherapy and was then switched back to two more AFTV
injections in January and February, 2021, in our clinic. The CT and
PET-CT images revealed complete response of her lung- and paraaortic
lymph node metastases, as shown in Fig. 1, a-h, series iii. She is
living well at present (cut-off, January 31, 2022).