Efficacy and Safety of Chemotherapy Following Anti-PD-1 Antibody Therapy for Gastric Cancer: A Case of Sclerosing Cholangitis
Efficacy and Safety of Chemotherapy Following Anti-PD-1 Antibody Therapy for Gastric Cancer: A Case of Sclerosing Cholangitis
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DOI：
10.2169/internalmedicine.1981-18
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发表时间：
2019-01-01
影响因子：
1.2
通讯作者：
Kudo, Masatoshi
中科院分区：
文献类型：
--
作者：
Kono, Masashi;Sakurai, Toshiharu;Kudo, Masatoshi
针对程序性细胞死亡-1（PD-1）信号的免疫治疗正在成为晚期胃癌的标准治疗。我们在此报告了一名胃腺癌伴腹膜播散的患者，他在纳武利尤单抗治疗后接受了白蛋白结合型紫杉醇和雷莫芦单抗治疗，并发生了硬化性胆管炎。内视镜逆行性胆道造影显示整个肝内胆道系统不规则的狭窄和增宽。有趣的是，在给予nivolumab之前接受nab-紫杉醇加雷莫芦单抗二线化疗的患者，他经历了疾病进展。此后，在纳武利尤单抗之后给予nab-紫杉醇和雷莫芦单抗的四线化疗导致临床应答。纳武利尤单抗可以增强后续化疗方案的疗效，但也会诱导硬化性胆管炎。
Immunotherapy targeting programmed cell death-1 (PD-1) signaling is becoming the standard of care for advanced gastric cancer. We herein report a patient with gastric adenocarcinoma with peritoneal dissemination who was treated with nab-paclitaxel and ramucirumab following nivolumab and developed sclerosing cholangitis. Endoscopic retrograde cholangiography showed irregular narrowing and widening of the entire intrahepatic biliary system. Intriguingly, the patient receiving second-line chemotherapy with nab-paclitaxel plus ramucirumab prior to being administered nivolumab, however, he had experienced progressive disease. Thereafter, the administration of fourth-line chemotherapy with nab-paclitaxel and ramucirumab following nivolumab resulted in a clinical response. Nivolumab may enhance the efficacy of the subsequent chemotherapy regimens but also induce sclerosing cholangitis.