Durable Response and Good Tolerance to the Triple Combination of Toripalimab, Gemcitabine, and Nab-Paclitaxel in a Patient With Metastatic Pancreatic Ductal Adenocarcinoma

Durable Response and Good Tolerance to the Triple Combination of Toripalimab, Gemcitabine, and Nab-Paclitaxel in a Patient With Metastatic Pancreatic Ductal Adenocarcinoma
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特瑞普利单抗、吉西他滨和白蛋白结合型紫杉醇三联疗法在转移性胰腺导管腺癌患者中的持久反应和良好耐受性

DOI:
10.3389/fimmu.2020.01127
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发表时间:
2020-06
影响因子:
7.3
通讯作者:
Shuangshuang Li
Shuangshuang Li
中科院分区:
医学2区
文献类型:
--
作者:
Cheng Yi;Xiaofen Li;Dan Cao;Lin Shui;Ke Cheng;Jian Li;Yang Peng;Pixian Shui;Fengzhu Guo;Shuangshuang Li

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背景:免疫检查点抑制剂(ICI)单药治疗胰腺导管腺癌(PDAC)的效果令人失望。越来越多的证据表明,ICIs联合全身治疗在实体瘤的一线治疗中具有良好的疗效。病例介绍:我们报告了一例转移性PDAC患者,该患者对托帕利单抗(一种新型PD-1抑制剂)和吉西他滨加nab-紫杉醇(GA)联合治疗有长期部分缓解和良好耐受性。肝转移灶中PD-L1阳性表达。此外,我们还描述了该患者在治疗过程中出现的伪进展现象。结论:GA联合托帕利单抗作为转移性PDAC患者的一线治疗方案,具有良好的疗效和可控的毒性。需要进一步的临床试验来证实这一结果。在接受免疫治疗的患者中,伪进展需要特别注意并与真进展区分开来。
Background: The performance of immune checkpoint inhibitor (ICI) monotherapy was proved to be disappointing in pancreatic ductal adenocarcinoma (PDAC). Increasing evidence has shown the promising efficacy of ICIs combined with systemic therapy in the first-line treatment in solid tumors. Case presentation: We reported a case of a metastatic PDAC patient who had a long-term partial response and good tolerance to the combined approach of toripalimab (a novel PD-1 inhibitor) and gemcitabine plus nab-paclitaxel (GA). PD-L1 positive expression was detected in his liver metastases. Besides, we described a phenomenon of pseudo-progression of this patient during the course of therapy. Conclusion: As the first-line treatment of metastatic PDAC patients, GA plus toripalimab may provide a novel combined approach with favorable response and manageable toxicity. Further clinical trials are needed to confirm the results. Pseudo-progression requires special attention and to be differentiated with true progression in patients undergoing immunotherapy.
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