Multimodal Conversion Therapy with TACE, Zimberelimab, Lenvatinib and S-1, Followed by Debulking Surgery to Prolong Survival for Gallbladder Cancer with Liver Metastasis: A Case Report

Abstract

Currently, the prognosis of gallbladder cancer (GBC) with liver metastasis is very poor upon the standard first-line chemotherapy or immunochemotherapy. The published articles supported surgery following multimodal conversion therapy of systemic and locoregional treatment might be a feasible way to prolong survival of GBC with liver metastasis. Herein, we reported a 65-year-old female of GBC with locoregional lymph nodes, blood vessels invasion and liver metastasis in clinical practice. She initiated systemic treatment (zimberelimab and lenvatinib) combined with transcatheter arterial chemoembolization (TACE), and successfully underwent palliative cholecystectomy and partial hepatectomy after 1 course treatment. Then she resumed systemic treatment (zimberelimab, lenvatinib plus S-1) and another TACE on demand, and subsequently received resection of liver metastasis 7 months later. To date, the patient has been achieving a progression-free survival of 13 months from diagnosis. Our case hints that surgery following conversion therapy of systemic and locoregional treatment is a potential way to improve the outcome of GBC with liver metastasis.