PDF(Sci-hub)
Abstract：
BACKGROUND: To date, no biomarkers exist to predict response or resistance to immunotherapy in hepatocellular carcinoma (HCC). Recent approaches to classify HCC into different immunological states revealed a negative correlation between Wnt/ß-catenin activation and immunogenicity and T-cell infiltration. If these \"cold\" tumors with primary resistance to checkpoint inhibition (CPI) may benefit from dual treatment of CPI and anti-angiogenic therapy has not been proved.
METHODS: Here, we describe the case of a male patient with metastatic HCC. After failure of standard of care treatment with lenvatinib, sorafenib and ramucirumab fourth-line systemic therapy with atezolizumab and bevacizumab were applied leading to a phenomenal response. Immunohistochemical evaluations were compatible with Wnt/ß-catenin pathway activation and accompanying low T-cell infiltration as well as low PD-L1 score.
CONCLUSIONS: Patients with Wnt/ß-catenin activation may benefit from combination therapy with atezolizumab and bevacizumab regardless of potential predictive markers for immune checkpoint inhibition.
METHODS: Here, we describe the case of a male patient with metastatic HCC. After failure of standard of care treatment with lenvatinib, sorafenib and ramucirumab fourth-line systemic therapy with atezolizumab and bevacizumab were applied leading to a phenomenal response. Immunohistochemical evaluations were compatible with Wnt/ß-catenin pathway activation and accompanying low T-cell infiltration as well as low PD-L1 score.
CONCLUSIONS: Patients with Wnt/ß-catenin activation may benefit from combination therapy with atezolizumab and bevacizumab regardless of potential predictive markers for immune checkpoint inhibition.
摘要：
背景：迄今为止，在肝细胞癌（HCC）中，没有生物标志物可以预测对免疫治疗的反应或耐药性。最近将HCC分类为不同免疫状态的方法揭示了Wnt/β-catenin激活与免疫原性和T细胞浸润之间的负相关。如果这些对检查点抑制（CPI）具有主要抗性的“冷”肿瘤可能受益于CPI和抗血管生成疗法的双重治疗尚未得到证实。
方法：这里，我们描述了一名男性转移性HCC患者的情况。lenvatinib标准治疗失败后，索拉非尼和雷莫西单抗四线全身治疗与阿特珠单抗和贝伐单抗一起应用,导致显著的缓解.免疫组织化学评估与Wnt/β-catenin途径激活和伴随的低T细胞浸润以及低PD-L1评分相容。
结论：Wnt/β-catenin激活的患者可能受益于阿特珠单抗和贝伐单抗的联合治疗，而不考虑免疫检查点抑制的潜在预测标志物。
方法：这里，我们描述了一名男性转移性HCC患者的情况。lenvatinib标准治疗失败后，索拉非尼和雷莫西单抗四线全身治疗与阿特珠单抗和贝伐单抗一起应用,导致显著的缓解.免疫组织化学评估与Wnt/β-catenin途径激活和伴随的低T细胞浸润以及低PD-L1评分相容。
结论：Wnt/β-catenin激活的患者可能受益于阿特珠单抗和贝伐单抗的联合治疗，而不考虑免疫检查点抑制的潜在预测标志物。
