UNASSIGNED: A 66-year-old female patient with ICC rapidly developed systemic multiple metastases after surgery, and the first-line two-drug combination chemotherapy was not effective. Due to cyclin-dependent kinase inhibitor 2A mutation and programmed cell death-ligand 1-positive, a partial response and progression-free survival of 9.5 months were achieved after a second-line treatment with cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) combined with immunotherapy. The patient developed thromboembolism 7 months after treatment and died due to disseminated intravascular coagulation.
UNASSIGNED: The combination of targeted and immune therapy has revealed a potentially effective regimen for the effective treatment of patients with ICC, which needs to be observed in larger clinical studies. The thromboembolism rates in real-world patients treated with CDK4/6 inhibitors are higher than those reported in clinical trials, and the application of prophylactic anticoagulation in this patient population may be questionable.
■一名66岁女性ICC患者在手术后迅速发展为全身多发转移,一线两药联合化疗无效.由于细胞周期蛋白依赖性激酶抑制剂2A突变和程序性细胞死亡-配体1阳性,细胞周期素依赖性激酶4/6抑制剂(CDK4/6i)二线治疗联合免疫治疗后,部分缓解,无进展生存期为9.5个月.患者治疗后7个月出现血栓栓塞,因弥散性血管内凝血死亡。
■靶向和免疫治疗的结合揭示了一种潜在的有效治疗ICC患者的有效方案,这需要在更大的临床研究中观察。使用CDK4/6抑制剂治疗的真实世界患者的血栓栓塞率高于临床试验中报道的水平。预防性抗凝治疗在该患者人群中的应用可能值得怀疑。