A PD-L1 Negative Advanced Gastric Cancer Patient With a Long Response to PD-1 Blockade After Failure of Systematic Treatment: A Case Report

Zhang, Fangyuan; Zhang, Jieying; Zhao, Lei; Zhai, Menglan; Zhang, Tao; Yu, Dandan

doi:10.3389/fimmu.2021.759250

Cited by 12 publications

(10 citation statements)

References 17 publications

(19 reference statements)

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“…Similarly, the results of immune cell analysis confirmed that levels of both CD45 + and CD8 + T cells were significantly higher after nivolumab intervention. Consistent with the data from previous studies ( 31 , 32 ), these results provide further evidence that PD-L1 expression is not a direct indicator of the tumor suppressive activity of immune checkpoint inhibitors, as nivolumab sharply suppressed tumor activity despite the absence of PD-L1 in the tumor.…”

Section: Discussionsupporting

confidence: 91%

“…PD-L1 expression is an initial screening marker for tumor patients receiving immunotherapy. However, some reports have demonstrated that the expression of PD-L1 is not fully indicative of the effect of immunotherapy ( 31 , 32 ). Indeed, some patients with low expression of PD-L1 still achieve good therapeutic results following PD-L1 antibody treatment.…”

Section: Discussionmentioning

confidence: 99%

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Screening of an individualized treatment strategy for an advanced gallbladder cancer using patient-derived tumor xenograft and organoid models

Tan

An²,

Gong³

et al. 2022

Front. Oncol.

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Gallbladder cancer is a highly aggressive malignancy with poor sensitivity to postoperative radiotherapy or chemotherapy; therefore, the development of individualized treatment strategies is paramount to improve patient outcomes. Both patient-derived tumor xenograft (PDX) and patient-derived tumor organoid (PDO) models derived from surgical specimens can better preserve the biological characteristics and heterogeneity of individual original tumors, display a unique advantage for individualized therapy and predicting clinical outcomes. In this study, PDX and PDO models of advanced gallbladder cancer were established, and the consistency of biological characteristics between them and primary patient samples was confirmed using pathological analysis and RNA-sequencing. Additionally, we tested the efficacy of chemotherapeutic drugs, targeted drugs, and immune checkpoint inhibitors using these two models. The results demonstrated that gemcitabine combined with cisplatin induced significant therapeutic effects. Furthermore, treatment with immune checkpoint inhibitors elicited promising responses in both the humanized mice and PDO immune models. Based on these results, gemcitabine combined with cisplatin was used for basic treatment, and immune checkpoint inhibitors were applied as a complementary intervention for gallbladder cancer. The patient responded well to treatment and exhibited a clearance of tumor foci. Our findings indicate that the combined use of PDO and PDX models can guide the clinical treatment course for gallbladder cancer patients to achieve individualized and effective treatment.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Screening of an individualized treatment strategy for an advanced gallbladder cancer using patient-derived tumor xenograft and organoid models

Tan

An²,

Gong³

et al. 2022

Front. Oncol.

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“…The ECOG PS 1 in our case confirmed that the prognosis of patients with a PS of ≤1 is better than in those with a PS of ≥2 (40). In contrast, it has been reported that for GC PD-L1-negative patients with highefficiency mismatch repair (PMMR)/MSS and TMB-1, immune checkpoint blockade can also achieve good outcomes after systematic treatment failure (41)(42)(43). One article reported that a patient received only four doses of nivolumab, discontinued any anti-tumor treatment in the next 12 months, and successfully achieved complete remission and long-term maintenance.…”

Section: Discussionsupporting

confidence: 69%

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“…The ECOG PS 1 in our case confirmed that the prognosis of patients with a PS of ≤1 is better than in those with a PS of ≥2 ( 40 ). In contrast, it has been reported that for GC PD-L1-negative patients with high-efficiency mismatch repair (PMMR)/MSS and TMB-1, immune checkpoint blockade can also achieve good outcomes after systematic treatment failure ( 41 – 43 ). One article reported that a patient received only four doses of nivolumab, discontinued any anti-tumor treatment in the next 12 months, and successfully achieved complete remission and long-term maintenance.…”

Section: Discussionmentioning

confidence: 98%

Case Report: Complete Remission of a Patient With Metastatic Gastric Cancer Treated With Nivolumab Combined With Chemotherapy After Palliative Surgery

et al. 2022

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Metastatic advanced gastric cancer, for which treatment strategies are extremely limited, has a poor prognosis. Complete remission is rare. Patients usually lose the opportunity of therapeutic surgery because the lesions cannot be completely removed, although it can greatly prolong their survival time. Palliative surgery usually suggests bad outcomes. In recent years, the immune checkpoint inhibitor (ICI) nivolumab has shown significant efficacy in the treatment of advanced gastric cancer. However, its applicable conditions and optimal withdrawal time remain controversial owing to its low response rate and high incidence of immune-related adverse events. Herein, we introduce a 66-year-old male patient with advanced gastric cancer with multiple liver metastases who underwent laparoscopic total gastrectomy for acute gastric bleeding. The patient received eight cycles of S-1 plus oxaliplatin (SOX) and switched to eight cycles of SOX plus nivolumab combined regimen in a stable state, later achieving complete remission. There was no recurrence for 32 months after the surgery. This is the first reported case of gastric cancer with multiple liver metastases with long-term complete remission with nivolumab treatment after palliative surgery. The potential mechanism of complete remission was discussed through clinical, genomic, and immune characteristics. The patient had a history of psoriasis and was positive for programmed death ligand 1 (PD-L1), and the interaction of TP53 mutation and HER-2 (-) gene may be associated with complete remission.

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A PD-L1 Negative Advanced Gastric Cancer Patient With a Long Response to PD-1 Blockade After Failure of Systematic Treatment: A Case Report

Cited by 12 publications

References 17 publications

Screening of an individualized treatment strategy for an advanced gallbladder cancer using patient-derived tumor xenograft and organoid models

Screening of an individualized treatment strategy for an advanced gallbladder cancer using patient-derived tumor xenograft and organoid models

DataSheet_1.docx

Case Report: Complete Remission of a Patient With Metastatic Gastric Cancer Treated With Nivolumab Combined With Chemotherapy After Palliative Surgery

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