Pseudoprogression During Enfortumab Vedotin Plus Pembrolizumab Therapy in Muscle-Invasive Bladder Cancer Achieving Pathological Complete Response: A Case Report.

Authors

Yosuke Nakanishi, Yohei Kawashima, Masanao Shinohara, Kazuhisa Hagiwara, Kohei Inui, Kazue Ogawa, Daiji Fujimori, Shingo Moriyama, Hanako Oba, Sato Satoshi

Published in

IJU case reports. Volume 9. Issue 6. Pages e70270. Epub Sep 25, 2026.

Abstract

Enfortumab vedotin plus pembrolizumab has emerged as a standard first-line therapy for advanced urothelial carcinoma (UC). However, pseudoprogression during this combination remains poorly characterized.
A 71-year-old man with muscle-invasive bladder cancer and lymph node metastasis received enfortumab vedotin plus pembrolizumab. During treatment, imaging suggested tumor progression with new hydronephrosis. Repeat transurethral resection revealed no viable tumor. Because of persistent symptoms, robot-assisted radical cystectomy was performed. Histopathological examination demonstrated no residual tumor cells, indicating pathological complete response (ypT0N0), with prominent CD8- and CD4-positive T-cell infiltration and minimal CD20-positive B-cell infiltration.
This case suggests that pseudoprogression may occur during enfortumab vedotin plus pembrolizumab therapy. Careful interpretation of radiological findings is essential to avoid premature treatment discontinuation.

PMID:
42800938
Bibliographic data and abstract were imported from PubMed on 27 Sep 2026.

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