Successful Treatment of Advanced Intrahepatic Cholangiocarcinoma With a High Tumor Mutational Burden and PD-L1 Expression by PD-1 Blockade Combined With Tyrosine Kinase Inhibitors: A Case Report

Frontiers in Immunology

Hongguang Wang¹  Zhanbo Wang²  Bingyang Hu⁵  Wenwen Zhang⁵  Ze Zhang⁵  Shichun Lu⁵ 

[1] Department of Hepatobiliary Surgery, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China;Department of Pathology, Chinese PLA General Hospital, Beijing, China;Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Beijing, China;Institute of Hepatobiliary Surgery of Chinese PLA, Beijing, China;Key Laboratory of Digital Hepatobiliary Surgery, PLA, Beijing, China;Medical School of Chinese People’s Liberation Army (PLA), Beijing, China;

关键词: intrahepatic cholangiocarcinoma;    immunotherapy;    conversion therapy;    PD-L1;    TMB;   

DOI  :  10.3389/fimmu.2021.744571

来源: DOAJ

【 摘 要 】

Advanced intrahepatic cholangiocarcinoma (iCCA) is not suitable for surgical treatment. Guided by the concept of precision medicine, preoperative systematic treatment may reshape the clinical outcomes of advanced intrahepatic cholangiocarcinoma patients. We describe the case of a 38-year-old female who has been diagnosed with stage IV intrahepatic cholangiocarcinoma with a high tumor mutational burden and positively programmed death-ligand 1 (PD-L1) expression. The patient was treated with programmed cell death 1 (PD-1) inhibitors combined with tyrosine kinase inhibitors (TKIs). After 7 cycles of combination therapy, she underwent radical resection and no tumor cells were found in the postoperative histopathological examination. In addition, the patient’s survival time had reached 25 months, as of August 2021. To date, this is the first case of successful radical resection after combined immunotherapy with TKIs for advanced PD-L1-positive intrahepatic cholangiocarcinoma with a high tumor mutational burden (TMB). The case provides a new approach to the treatment of advanced intrahepatic cholangiocarcinoma.

【 授权许可】

Unknown