Case report: Remarkable response to sintilimab, lenvatinib, and nab-paclitaxel in postoperative metastatic chemotherapy-resistant combined hepatocellular-cholangiocarcinoma
Background: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a highly aggressive malignancy with a poor prognosis. However, there are no consensus treatment guidelines, and decisions are usually extrapolated from intrahepatic cholangiocarcinoma (ICC) or hepatocellular carcinoma (HCC). Given...
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Frontiers Media S.A.
2023-10-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1190967/full |
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| author | Nan Zhou Nan Zhou Chuan-Fen Lei Chuan-Fen Lei Si-Rui Tan Si-Rui Tan Qi-Yue Huang Qi-Yue Huang Shun-Yu Zhang Shun-Yu Zhang Zheng-Xin Liang Hong-Feng Gou Hong-Feng Gou |
| author_facet | Nan Zhou Nan Zhou Chuan-Fen Lei Chuan-Fen Lei Si-Rui Tan Si-Rui Tan Qi-Yue Huang Qi-Yue Huang Shun-Yu Zhang Shun-Yu Zhang Zheng-Xin Liang Hong-Feng Gou Hong-Feng Gou |
| author_sort | Nan Zhou |
| collection | DOAJ |
| description | Background: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a highly aggressive malignancy with a poor prognosis. However, there are no consensus treatment guidelines, and decisions are usually extrapolated from intrahepatic cholangiocarcinoma (ICC) or hepatocellular carcinoma (HCC). Given that cHCC-CCA owns the unequivocal presence of both hepatocytic and cholangiocytic differentiation, a combination regimen of anti-PD1 antibody, multikinase inhibitor, and chemotherapy targeting against both components might be an optimal choice.Case presentation: We present the case of a patient with postoperative metastatic chemotherapy-resistant cHCC-CCA who exhibited a durable response and reasonable tolerability to a combination therapy consisting of the anti-PD1 antibody sintilimab, multikinase inhibitor lenvatinib, and nab-paclitaxel, despite having a low tumor mutational burden (TMB-L), microsatellite stability (MSS), and negative programmed cell death 1 ligand 1 (PD-L1).Conclusion: The combination regimen of immune checkpoint inhibitor sintilimab, multikinase inhibitor lenvatinib, and chemotherapy with nab-paclitaxel, which targets both the HCC and ICC components, may represent a promising treatment option for patients with cHCC-CCA. Further research is warranted to validate these findings in larger patient cohorts. |
| first_indexed | 2024-03-11T18:35:05Z |
| format | Article |
| id | doaj.art-9433a3c87dd748cc804f8ae5daa6699c |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-03-11T18:35:05Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-9433a3c87dd748cc804f8ae5daa6699c2023-10-13T05:04:13ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-10-011410.3389/fphar.2023.11909671190967Case report: Remarkable response to sintilimab, lenvatinib, and nab-paclitaxel in postoperative metastatic chemotherapy-resistant combined hepatocellular-cholangiocarcinomaNan Zhou0Nan Zhou1Chuan-Fen Lei2Chuan-Fen Lei3Si-Rui Tan4Si-Rui Tan5Qi-Yue Huang6Qi-Yue Huang7Shun-Yu Zhang8Shun-Yu Zhang9Zheng-Xin Liang10Hong-Feng Gou11Hong-Feng Gou12Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaGastric Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaDepartment of Pathology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaGastric Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaGastric Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaGastric Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Urology, The Second Hospital of Tianjin Medical University, Tianjin, ChinaDepartment of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, ChinaGastric Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaBackground: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a highly aggressive malignancy with a poor prognosis. However, there are no consensus treatment guidelines, and decisions are usually extrapolated from intrahepatic cholangiocarcinoma (ICC) or hepatocellular carcinoma (HCC). Given that cHCC-CCA owns the unequivocal presence of both hepatocytic and cholangiocytic differentiation, a combination regimen of anti-PD1 antibody, multikinase inhibitor, and chemotherapy targeting against both components might be an optimal choice.Case presentation: We present the case of a patient with postoperative metastatic chemotherapy-resistant cHCC-CCA who exhibited a durable response and reasonable tolerability to a combination therapy consisting of the anti-PD1 antibody sintilimab, multikinase inhibitor lenvatinib, and nab-paclitaxel, despite having a low tumor mutational burden (TMB-L), microsatellite stability (MSS), and negative programmed cell death 1 ligand 1 (PD-L1).Conclusion: The combination regimen of immune checkpoint inhibitor sintilimab, multikinase inhibitor lenvatinib, and chemotherapy with nab-paclitaxel, which targets both the HCC and ICC components, may represent a promising treatment option for patients with cHCC-CCA. Further research is warranted to validate these findings in larger patient cohorts.https://www.frontiersin.org/articles/10.3389/fphar.2023.1190967/fullcombined hepatocellular-cholangiocarcinoma (cHCC-CCA)sintilimablenvatinibnabpaclitaxelsecond-line treatment |
| spellingShingle | Nan Zhou Nan Zhou Chuan-Fen Lei Chuan-Fen Lei Si-Rui Tan Si-Rui Tan Qi-Yue Huang Qi-Yue Huang Shun-Yu Zhang Shun-Yu Zhang Zheng-Xin Liang Hong-Feng Gou Hong-Feng Gou Case report: Remarkable response to sintilimab, lenvatinib, and nab-paclitaxel in postoperative metastatic chemotherapy-resistant combined hepatocellular-cholangiocarcinoma Frontiers in Pharmacology combined hepatocellular-cholangiocarcinoma (cHCC-CCA) sintilimab lenvatinib nabpaclitaxel second-line treatment |
| title | Case report: Remarkable response to sintilimab, lenvatinib, and nab-paclitaxel in postoperative metastatic chemotherapy-resistant combined hepatocellular-cholangiocarcinoma |
| title_full | Case report: Remarkable response to sintilimab, lenvatinib, and nab-paclitaxel in postoperative metastatic chemotherapy-resistant combined hepatocellular-cholangiocarcinoma |
| title_fullStr | Case report: Remarkable response to sintilimab, lenvatinib, and nab-paclitaxel in postoperative metastatic chemotherapy-resistant combined hepatocellular-cholangiocarcinoma |
| title_full_unstemmed | Case report: Remarkable response to sintilimab, lenvatinib, and nab-paclitaxel in postoperative metastatic chemotherapy-resistant combined hepatocellular-cholangiocarcinoma |
| title_short | Case report: Remarkable response to sintilimab, lenvatinib, and nab-paclitaxel in postoperative metastatic chemotherapy-resistant combined hepatocellular-cholangiocarcinoma |
| title_sort | case report remarkable response to sintilimab lenvatinib and nab paclitaxel in postoperative metastatic chemotherapy resistant combined hepatocellular cholangiocarcinoma |
| topic | combined hepatocellular-cholangiocarcinoma (cHCC-CCA) sintilimab lenvatinib nabpaclitaxel second-line treatment |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1190967/full |
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