PDF(Pubmed)
Abstract：
Patients with advanced intrahepatic cholangiocarcinoma (iCCA) often have a poor prognosis. Recent advancements in targeted molecular therapy and immunotherapy have been made. Herein, we report a case of advanced iCCA treated with a combination of pemigatinib (a selective FGFR inhibitor), chemotherapy, and an immune checkpoint inhibitor. A 34-year-old female was diagnosed with advanced iCCA with multiple liver masses and metastases in the peritoneum and lymph nodes. Next-generation sequencing (NGS) identified the genetic mutations. An FGFR2-BICC1 gene fusion was found in this patient. The patient was treated with pemigatinib in combination with pembrolizumab plus systemic gemcitabine and oxaliplatin. After 9 cycles of the combination therapy, the patient achieved a partial response, complete metabolic response, and normalization of tumor markers. Sequentially, the patient received pemigatinib and pembrolizumab for 3 months. Due to the elevated tumor biomarker, she is currently receiving chemotherapy, pemigatinib, and pembrolizumab treatment again. She regained an excellent physical status after 16 months of treatment. To the best of our knowledge, this was the first reported case of advanced iCCA successfully treated with a combination of pemigatinib, chemotherapy, and ICIs as a first-line regimen. This treatment combination may be effective and safe in the advanced iCCA.
摘要：
晚期肝内胆管癌（iCCA）患者通常预后不良。靶向分子治疗和免疫疗法的最新进展已经取得。在这里，我们报告一例晚期iCCA联合pemigatinib（一种选择性FGFR抑制剂）治疗，化疗,和免疫检查点抑制剂。一名34岁的女性被诊断为晚期iCCA，伴有多个肝脏肿块和腹膜和淋巴结转移。下一代测序（NGS）鉴定了基因突变。在该患者中发现了FGFR2-BICC1基因融合体。患者接受培米替尼联合派姆单抗联合全身吉西他滨和奥沙利铂治疗。经过9个周期的联合治疗，病人取得了部分反应，完整的代谢反应，和肿瘤标志物的正常化。按顺序,患者接受培米替尼和派博利珠单抗治疗3个月.由于肿瘤生物标志物升高，她目前正在接受化疗，pemigatinib,和pembrolizumab再次治疗。经过16个月的治疗，她恢复了良好的身体状况。据我们所知,这是首次报道的pemigatinib联合成功治疗的晚期iCCA病例，化疗,和ICIs作为一线方案。这种治疗组合在晚期iCCA中可能是有效和安全的。
