A case of long-term complete remission of locally advanced T4 bladder cancer treated with pembrolizumab

A 69-year-old man with a history of non-muscle invasive bladder cancer 12 years ago presented complaining of gross hematuria. He was diagnosed as having invasive T4 bladder cancer with invasion to a branch of the internal iliac artery and received platinum-based chemo-radiation therapy. However, the tumor progressed to extensively infiltrate the pelvic wall, and left leg pain and swelling developed. Pembrolizumab was started, which entirely resolved the tumor after 14 courses of treatment. Pembrolizumab was discontinued after 20 courses of treatment because of adverse events. However, the patient has remained in complete response for over 2 years after pembrolizumab cessation.