Complete response to immunotherapy in a metastatic lymphoepithelioma-like bladder carcinoma: a case report

Lymphoepithelioma-like carcinoma of the bladder (LELC-B) is a very rare variant of bladder carcinoma, has a good prognosis, and possibly a high response to platinum-based chemotherapy (ChT) and immune-checkpoint inhibitors (ICI). This is the case of a male patient that presented a metastatic relapse of a LELC-B, the disease progressed after platinum based first line ChT. Second line with atezolizumab was initiated with progressive tumor shrinking until complete response was achieved. Final atezolizumab discontinuation was decided in agreement with the patient after 3 years of maintenance of complete response. After the experience of this case and the few cases of neoadjuvant treatment with pembrolizumab of localized disease, it seems that immunotherapy may play a main role in the treatment of this variant of bladder carcinoma.