1 INTRODUCTION
In clinical settings for cancer patients, doctors may have experienced strong rejection of a rational treatment because of patient’s fear of severe adverse effects of the proposed treatments. If no more options are available among the governmentally-approved treatments, we should have to select unapproved but humane treatments for the patient without considering health insurance. Autologous formalin-fixed tumor vaccine (AFTV) is one of such treatment options that has been exceptionally allowed in Japan and Germany. Here, we report on a patient with a stage IV uterine carcinoma who initially rejected chemotherapy and anti-PD-1 antibody treatment despite the presence of apparent circulating tumor cells (CTC) that were sensitive to paclitaxel and carboplatin and carried microsatellite instability (MSI).