Case report: Robust response to sintilimab in advanced distal cholangiocarcinoma with PD-L1 expression and DNA damage repair
Cholangiocarcinoma (CCA) is a highly heterogeneous tumor that occurs in the bile duct epithelium; adenosquamous carcinoma is a rare pathological subtype of CCA. The clinical treatment of patients with metastatic distal CCA poses significant challenges. We report a 53-year-old female diagnosed with a...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-04-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1336699/full |
| _version_ | 1797215975731363840 |
|---|---|
| author | Wenguang He Congcong Song Jiwei Ren Xiao Ji Xiuyan Wang Lixia Liu |
| author_facet | Wenguang He Congcong Song Jiwei Ren Xiao Ji Xiuyan Wang Lixia Liu |
| author_sort | Wenguang He |
| collection | DOAJ |
| description | Cholangiocarcinoma (CCA) is a highly heterogeneous tumor that occurs in the bile duct epithelium; adenosquamous carcinoma is a rare pathological subtype of CCA. The clinical treatment of patients with metastatic distal CCA poses significant challenges. We report a 53-year-old female diagnosed with a stage III adenosquamous carcinomas of distal CCA. Metastasis occurred 4 months postoperatively and she was diagnosed with stage IV disease. The patient was treated with Gemcitabine + Oxaliplatin (GEMOX) and Capecitabine + Oxaliplatin (CAPEOX), followed by sintilimab monotherapy. After two cycles of treatment, the patient achieved partial response (PR) and the lesion continued to shrink. After 37 months of follow-up, the patient’s liver metastasis had almost completely disappeared, and complete response (CR) was achieved. Moreover, she had more than 46 months of disease progression-free survival (PFS). Immunohistochemical testing showed high expression of PD-L1, and next-generation sequencing revealed the presence of mutations in DNA damage repair (DDR) pathway genes. To the best of our knowledge, this is the first reported case of the successful treatment of metastatic distal adenosquamous CCA with sintilimab alone. Remarkably, patients of CCA with high PD-L1 expression and DDR pathway gene mutations may benefit from sintilimab treatment. |
| first_indexed | 2024-04-24T11:38:37Z |
| format | Article |
| id | doaj.art-a218675e3fbd445b803e49e543b83fca |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-24T11:38:37Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-a218675e3fbd445b803e49e543b83fca2024-04-10T04:28:15ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-04-011510.3389/fphar.2024.13366991336699Case report: Robust response to sintilimab in advanced distal cholangiocarcinoma with PD-L1 expression and DNA damage repairWenguang He0Congcong Song1Jiwei Ren2Xiao Ji3Xiuyan Wang4Lixia Liu5Traditional Chinese Medicine Department, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaShenzhen Engineering Center for Translational Medicine of Precision Cancer Immunodiagnosis and Therapy, YuceBio Technology Co., Ltd., Shenzhen, ChinaTraditional Chinese Medicine Department, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaTraditional Chinese Medicine Department, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaShenzhen Engineering Center for Translational Medicine of Precision Cancer Immunodiagnosis and Therapy, YuceBio Technology Co., Ltd., Shenzhen, ChinaTraditional Chinese Medicine Department, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaCholangiocarcinoma (CCA) is a highly heterogeneous tumor that occurs in the bile duct epithelium; adenosquamous carcinoma is a rare pathological subtype of CCA. The clinical treatment of patients with metastatic distal CCA poses significant challenges. We report a 53-year-old female diagnosed with a stage III adenosquamous carcinomas of distal CCA. Metastasis occurred 4 months postoperatively and she was diagnosed with stage IV disease. The patient was treated with Gemcitabine + Oxaliplatin (GEMOX) and Capecitabine + Oxaliplatin (CAPEOX), followed by sintilimab monotherapy. After two cycles of treatment, the patient achieved partial response (PR) and the lesion continued to shrink. After 37 months of follow-up, the patient’s liver metastasis had almost completely disappeared, and complete response (CR) was achieved. Moreover, she had more than 46 months of disease progression-free survival (PFS). Immunohistochemical testing showed high expression of PD-L1, and next-generation sequencing revealed the presence of mutations in DNA damage repair (DDR) pathway genes. To the best of our knowledge, this is the first reported case of the successful treatment of metastatic distal adenosquamous CCA with sintilimab alone. Remarkably, patients of CCA with high PD-L1 expression and DDR pathway gene mutations may benefit from sintilimab treatment.https://www.frontiersin.org/articles/10.3389/fphar.2024.1336699/fullcholangiocarcinomasintilimabPD-L1DNA damage repaircomplete response |
| spellingShingle | Wenguang He Congcong Song Jiwei Ren Xiao Ji Xiuyan Wang Lixia Liu Case report: Robust response to sintilimab in advanced distal cholangiocarcinoma with PD-L1 expression and DNA damage repair Frontiers in Pharmacology cholangiocarcinoma sintilimab PD-L1 DNA damage repair complete response |
| title | Case report: Robust response to sintilimab in advanced distal cholangiocarcinoma with PD-L1 expression and DNA damage repair |
| title_full | Case report: Robust response to sintilimab in advanced distal cholangiocarcinoma with PD-L1 expression and DNA damage repair |
| title_fullStr | Case report: Robust response to sintilimab in advanced distal cholangiocarcinoma with PD-L1 expression and DNA damage repair |
| title_full_unstemmed | Case report: Robust response to sintilimab in advanced distal cholangiocarcinoma with PD-L1 expression and DNA damage repair |
| title_short | Case report: Robust response to sintilimab in advanced distal cholangiocarcinoma with PD-L1 expression and DNA damage repair |
| title_sort | case report robust response to sintilimab in advanced distal cholangiocarcinoma with pd l1 expression and dna damage repair |
| topic | cholangiocarcinoma sintilimab PD-L1 DNA damage repair complete response |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1336699/full |
| work_keys_str_mv | AT wenguanghe casereportrobustresponsetosintilimabinadvanceddistalcholangiocarcinomawithpdl1expressionanddnadamagerepair AT congcongsong casereportrobustresponsetosintilimabinadvanceddistalcholangiocarcinomawithpdl1expressionanddnadamagerepair AT jiweiren casereportrobustresponsetosintilimabinadvanceddistalcholangiocarcinomawithpdl1expressionanddnadamagerepair AT xiaoji casereportrobustresponsetosintilimabinadvanceddistalcholangiocarcinomawithpdl1expressionanddnadamagerepair AT xiuyanwang casereportrobustresponsetosintilimabinadvanceddistalcholangiocarcinomawithpdl1expressionanddnadamagerepair AT lixialiu casereportrobustresponsetosintilimabinadvanceddistalcholangiocarcinomawithpdl1expressionanddnadamagerepair |