Case Report: Persistent response to combination therapy of pemigatinib, chemotherapy, and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinoma
Patients with advanced intrahepatic cholangiocarcinoma (iCCA) often have a poor prognosis. Recent advancements in targeted molecular therapy and immunotherapy have been made. Herein, we report a case of advanced iCCA treated with a combination of pemigatinib (a selective FGFR inhibitor), chemotherap...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1124482/full |
| _version_ | 1797821298677645312 |
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| author | Zhuochao Zhang Zhuochao Zhang Gaofei Wang Lei Du Jie Zhao Lichao Pan Lichao Pan Gong Zhang Gong Zhang Gong Zhang Fei Wang Fei Wang Rong Liu Rong Liu |
| author_facet | Zhuochao Zhang Zhuochao Zhang Gaofei Wang Lei Du Jie Zhao Lichao Pan Lichao Pan Gong Zhang Gong Zhang Gong Zhang Fei Wang Fei Wang Rong Liu Rong Liu |
| author_sort | Zhuochao Zhang |
| collection | DOAJ |
| description | Patients with advanced intrahepatic cholangiocarcinoma (iCCA) often have a poor prognosis. Recent advancements in targeted molecular therapy and immunotherapy have been made. Herein, we report a case of advanced iCCA treated with a combination of pemigatinib (a selective FGFR inhibitor), chemotherapy, and an immune checkpoint inhibitor. A 34-year-old female was diagnosed with advanced iCCA with multiple liver masses and metastases in the peritoneum and lymph nodes. Next-generation sequencing (NGS) identified the genetic mutations. An FGFR2-BICC1 gene fusion was found in this patient. The patient was treated with pemigatinib in combination with pembrolizumab plus systemic gemcitabine and oxaliplatin. After 9 cycles of the combination therapy, the patient achieved a partial response, complete metabolic response, and normalization of tumor markers. Sequentially, the patient received pemigatinib and pembrolizumab for 3 months. Due to the elevated tumor biomarker, she is currently receiving chemotherapy, pemigatinib, and pembrolizumab treatment again. She regained an excellent physical status after 16 months of treatment. To the best of our knowledge, this was the first reported case of advanced iCCA successfully treated with a combination of pemigatinib, chemotherapy, and ICIs as a first-line regimen. This treatment combination may be effective and safe in the advanced iCCA. |
| first_indexed | 2024-03-13T09:50:54Z |
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| id | doaj.art-8ab02f5ff1bf4a188112f163f4b90044 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-03-13T09:50:54Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-8ab02f5ff1bf4a188112f163f4b900442023-05-24T10:16:38ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-05-011410.3389/fimmu.2023.11244821124482Case Report: Persistent response to combination therapy of pemigatinib, chemotherapy, and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinomaZhuochao Zhang0Zhuochao Zhang1Gaofei Wang2Lei Du3Jie Zhao4Lichao Pan5Lichao Pan6Gong Zhang7Gong Zhang8Gong Zhang9Fei Wang10Fei Wang11Rong Liu12Rong Liu13Faculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, ChinaKey Laboratory of Digital Hepetobiliary Surgery, PLA, Beijing, ChinaDepartment of Pathology, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, ChinaDepartment of Nuclear Medicine, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, ChinaFaculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, ChinaFaculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, ChinaKey Laboratory of Digital Hepetobiliary Surgery, PLA, Beijing, ChinaFaculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, ChinaKey Laboratory of Digital Hepetobiliary Surgery, PLA, Beijing, ChinaMedical School of Chinese PLA, Beijing, ChinaFaculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, ChinaKey Laboratory of Digital Hepetobiliary Surgery, PLA, Beijing, ChinaFaculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, ChinaKey Laboratory of Digital Hepetobiliary Surgery, PLA, Beijing, ChinaPatients with advanced intrahepatic cholangiocarcinoma (iCCA) often have a poor prognosis. Recent advancements in targeted molecular therapy and immunotherapy have been made. Herein, we report a case of advanced iCCA treated with a combination of pemigatinib (a selective FGFR inhibitor), chemotherapy, and an immune checkpoint inhibitor. A 34-year-old female was diagnosed with advanced iCCA with multiple liver masses and metastases in the peritoneum and lymph nodes. Next-generation sequencing (NGS) identified the genetic mutations. An FGFR2-BICC1 gene fusion was found in this patient. The patient was treated with pemigatinib in combination with pembrolizumab plus systemic gemcitabine and oxaliplatin. After 9 cycles of the combination therapy, the patient achieved a partial response, complete metabolic response, and normalization of tumor markers. Sequentially, the patient received pemigatinib and pembrolizumab for 3 months. Due to the elevated tumor biomarker, she is currently receiving chemotherapy, pemigatinib, and pembrolizumab treatment again. She regained an excellent physical status after 16 months of treatment. To the best of our knowledge, this was the first reported case of advanced iCCA successfully treated with a combination of pemigatinib, chemotherapy, and ICIs as a first-line regimen. This treatment combination may be effective and safe in the advanced iCCA.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1124482/fulladvanced intrahepatic cholangiocarcinomacombined therapyFGFR inhibitorsimmune checkpoint inhibitorpemigatinib |
| spellingShingle | Zhuochao Zhang Zhuochao Zhang Gaofei Wang Lei Du Jie Zhao Lichao Pan Lichao Pan Gong Zhang Gong Zhang Gong Zhang Fei Wang Fei Wang Rong Liu Rong Liu Case Report: Persistent response to combination therapy of pemigatinib, chemotherapy, and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinoma Frontiers in Immunology advanced intrahepatic cholangiocarcinoma combined therapy FGFR inhibitors immune checkpoint inhibitor pemigatinib |
| title | Case Report: Persistent response to combination therapy of pemigatinib, chemotherapy, and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinoma |
| title_full | Case Report: Persistent response to combination therapy of pemigatinib, chemotherapy, and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinoma |
| title_fullStr | Case Report: Persistent response to combination therapy of pemigatinib, chemotherapy, and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinoma |
| title_full_unstemmed | Case Report: Persistent response to combination therapy of pemigatinib, chemotherapy, and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinoma |
| title_short | Case Report: Persistent response to combination therapy of pemigatinib, chemotherapy, and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinoma |
| title_sort | case report persistent response to combination therapy of pemigatinib chemotherapy and immune checkpoint inhibitor in a patient with advanced intrahepatic cholangiocarcinoma |
| topic | advanced intrahepatic cholangiocarcinoma combined therapy FGFR inhibitors immune checkpoint inhibitor pemigatinib |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1124482/full |
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