Successful pembrolizumab treatment of microsatellite instability‐high intrahepatic cholangiocarcinoma: A case report

Ikeda, Yuki; Ono, Michihiro; Ohmori, Ginji; Ameda, Saki; Yamada, Michiko; Abe, Tomoyuki; Fujii, Shigeyuki; Fujita, Miri

doi:10.1002/ccr3.4008

Cited by 8 publications

(6 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only a handful of cases of successful management of advanced CCA with pembrolizumab were reported in the literature (Table 1) [14][15][16][17]. All of these cases included advanced CCA with high MSI status that initially failed the recommended combined chemotherapy but achieved a good response to pembrolizumab.…”

Section: Discussionmentioning

confidence: 99%

A Case of Advanced Multifocal Cholangiocarcinoma With Excellent Response to Pembrolizumab

Habib¹,

Abu-Abaa²,

Gandhi³

2023

Cureus

View full text Add to dashboard Cite

The role of immune checkpoint inhibitors (ICIs) continues to receive more attention as evidence emerges of their efficacy and improved survival in patients with advanced biliary tract malignancies including cholangiocarcinoma (CCA). In line with this evidence, we describe the case of a 52-year-old male patient who presented initially in October 2019 with abdominal pain. Investigations revealed multifocal hepatic masses that proved to be CCA that was considered unresectable. Chemotherapy with cisplatin (C) and gemcitabine (G) was initiated. In January 2020, progressive disease was noted, prompting the initiation of 5-fluorouracil (5-FU) and oxaliplatin along with pembrolizumab. Since March 2020, pembrolizumab monotherapy was pursued with radiological evidence of excellent response. Pembrolizumab monotherapy was continued through August 2022, where positron emission tomography (PET)/CT scan showed no evidence of active disease. This case serves to supplement the ongoing evidence of ICI efficacy especially as a durable, sustained radiological response was evident for more than three years from the time of diagnosis.

show abstract

Section: Discussionmentioning

confidence: 99%

A Case of Advanced Multifocal Cholangiocarcinoma With Excellent Response to Pembrolizumab

Habib¹,

Abu-Abaa²,

Gandhi³

2023

Cureus

View full text Add to dashboard Cite

show abstract

“… 76 Recently, more studies have reported similar dramatic anti-tumour or even complete tumour responses. [77] , [78] , [79] , [80] …”

Section: Preclinical Cca Immunotherapymentioning

confidence: 99%

Preclinical and clinical studies of immunotherapy for the treatment of cholangiocarcinoma

Lu¹,

Green²,

Xie³

et al. 2023

JHEP Reports

View full text Add to dashboard Cite

“…However, almost half of all patients with CCA have immunologically 'cold' tumors and have low response rates to treatment with ICIs (136). Genetic abnormalities in tumor cells, such as defective DNA mismatch repair (dMMR) and microsatellite instability-high (MSI-H), can also influence the responsiveness of tumors to ICIs (137)(138)(139). Studies have suggested that patients with solid tumors that feature abundant CD8 + T cells, significant PD-L1 expression, MSI-H, high levels of dMMR and a high tumor mutation burden (TMB) may exhibit sensitivity to immunotherapy (140,141).…”

Section: Immunotherapy For Cholangiocarcinomamentioning

confidence: 99%

Tumor immune microenvironment and the current immunotherapy of cholangiocarcinoma (Review)

Yang,

Zou,

Dai

et al. 2023

Int J Oncol

View full text Add to dashboard Cite

Cholangiocarcinoma (CCA) is a highly heterogeneous malignancy originating from the epithelial system of the bile ducts, and its incidence in recent years is steadily increasing. The immune microenvironment of CCA is characterized by diversity and complexity, with a substantial presence of cancer-associated fibroblasts and immune cell infiltration, which plays a key role in regulating the distinctive biological behavior of cholangiocarcinoma, including tumor growth, angiogenesis, lymphangiogenesis, invasion and metastasis. Despite the notable success of immunotherapy in the treatment of solid tumors in recent years, patients with CCA have responded poorly to immune checkpoint inhibitor therapy. The interaction of tumor cells with cellular components of the immune microenvironment can regulate the activity and function of immune cells and form an immunosuppressive microenvironment, which may cause ineffective immunotherapy. Therefore, the components of the tumor immune microenvironment appear to be novel targets for immune therapies. Combination therapy focusing on immune checkpoint inhibitors is a promising and valuable first-line or translational treatment approach for intractable biliary tract malignancies. The present review discusses the compositional characteristics and regulatory factors of the CCA immune microenvironment and the possible immune escape mechanisms. In addition, a summary of the advances in immunotherapy for CCA is also provided. It is hoped that the present review may function as a valuable reference for the development of novel immunotherapeutic strategies for CCA.

show abstract

Successful pembrolizumab treatment of microsatellite instability‐high intrahepatic cholangiocarcinoma: A case report

Abstract: Key Clinical Message The tumor reduction effect of pembrolizumab is extremely high compared to standard chemotherapy and might show prolonged survival. Therefore, the MSI status should be examined in patients with cholangiocarcinoma.

Cited by 8 publications

References 16 publications

A Case of Advanced Multifocal Cholangiocarcinoma With Excellent Response to Pembrolizumab

A Case of Advanced Multifocal Cholangiocarcinoma With Excellent Response to Pembrolizumab

Preclinical and clinical studies of immunotherapy for the treatment of cholangiocarcinoma

Tumor immune microenvironment and the current immunotherapy of cholangiocarcinoma (Review)

Contact Info

Product

Resources

About