Abstract：
Intrahepatic cholangiocarcinoma (ICC) is a highly aggressive malignancy rising from the biliary tree with poor prognosis. We report the feasibility and efficacy of transarterial chemoembolization (TACE) combined with PD-1 inhibitor and apatinib for the treatment of a patient with unresectable ICC. A 70-year-old female presented with intermittent right upper abdominal distension, abdominal pain, and vomiting after eating for more than one month. Enhanced computed tomography (CT) and magnetic resonance imaging (MRI) scan revealed multiple intrahepatic lesions, retroperitoneal lymph node, and left lung metastasis. Based on the patient\'s medical history and pathology, the diagnosis was confirmed as locally advanced unresectable ICC. Multimodal therapy was applied to the ICC. The therapy comprised TACE every three months, and a combination regimen of the PD-1 inhibitor camrelizumab and the antiangiogenic agent apatinib. The patient underwent microwave ablation for a lesion on the left lung that had not responded to systemic therapies. Enhanced CT scan after every 2-3 months was performed. After several sessions, the primary lesion reduced dramatically in size. At 20 months from diagnosis, the patient was alive, in good condition, and stable. The patient experienced no critical complications and toxicity associated with the administered therapies. This case suggests that treatment with TACE combined with systemic therapy of camrelizumab combined with apatinib may be a safe and effective treatment option for patients with inoperable ICC.
摘要：
肝内胆管癌（ICC）是一种高度侵袭性的恶性肿瘤，从胆道树上升，预后不良。我们报告了经动脉化疗栓塞（TACE）联合PD-1抑制剂和阿帕替尼治疗不可切除ICC患者的可行性和疗效。一名70岁的女性出现间歇性右上腹胀，腹痛,进食超过一个月后呕吐。增强计算机断层扫描（CT）和磁共振成像（MRI）扫描显示多个肝内病变，腹膜后淋巴结,左肺转移。根据患者的病史和病理,确诊为局部晚期无法切除的ICC.多模式治疗应用于ICC。治疗包括每三个月进行一次TACE,以及PD-1抑制剂卡姆瑞珠单抗和抗血管生成药阿帕替尼的联合方案。患者接受了对全身治疗无反应的左肺损伤的微波消融。每2-3个月进行一次增强CT扫描。经过几次会议，原发病灶的大小明显缩小。诊断后20个月，病人还活着,状况良好,和稳定。患者没有经历与施用的疗法相关的严重并发症和毒性。该病例表明，TACE联合卡姆瑞珠单抗联合阿帕替尼的全身治疗可能是无法手术的ICC患者的安全有效的治疗选择。
