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Here, we present a case with a metastatic urothelial carcinoma who received nivolumab and palliative radiotherapy to a residual tumour in the vagina and to a large metastatic visceral lymph node. The treatment resulted in a rapid and virtually complete response for the time being in all metastases and in the large parailiac tumour mass. Follow up continues. The presented case demonstrates that the combinatory treatment with radiotherapy and immunotherapy can result in an exceptional response for the benefit of the patient with urothelial cancer. To our knowledge, this is one of the largest metastatic masses to disappear with a combination of immuno-oncologic (nivolumab) and radiation therapies.<\/jats:p>","DOI":"10.1136\/bcr-2021-246653","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T13:42:08Z","timestamp":1653313328000},"page":"e246653","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["A rare and complete response to combination therapy with radiation and nivolumab in a patient with metastatic urothelial cancer"],"prefix":"10.1136","volume":"15","author":[{"given":"Aki","family":"Hietala","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Urology, Lapland Central Hospital, Rovaniemi, Finland"},{"name":"Department of Urology, Oulu University, Oulu, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Joutsen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Lapland Central Hospital, Rovaniemi, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svea","family":"Vaarala","sequence":"additional","affiliation":[{"name":"Department of Oncology, Lapland Central Hospital, Rovaniemi, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matti","family":"S\u00e4ily","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, Lapland Central Hospital, Rovaniemi, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"2025082700072873000_15.5.e246653.1","unstructured":"Ferlay J , Laversanne M , Ervik M . 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