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Unexpected favorable outcome to sintilimab monotherapy in a relapse pancreatic ductal adenocarcinoma patient with high tumor mutational burden: a case report

The reason that immune checkpoint inhibitors have not been widely applied to pancreatic cancer treatment is probably because of low immunogenicity or dense stromal fibrosis. Recently, only pembrolizumab was recommended for DNA mismatch repair deficiency or high microsatellite instability by National...

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Autores principales: Zhang, Fan, Li, Xiaomin, Liu, Haisheng, Liu, Rongfeng, Zhou, Zhiguo, Zhang, Yi, Chen, Jingli, Tian, Ye, Pan, Chaohu, Meng, Qingju, Liu, Yibing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481288/
https://www.ncbi.nlm.nih.gov/pubmed/35946538
http://dx.doi.org/10.1097/CAD.0000000000001334
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author Zhang, Fan
Li, Xiaomin
Liu, Haisheng
Liu, Rongfeng
Zhou, Zhiguo
Zhang, Yi
Chen, Jingli
Tian, Ye
Pan, Chaohu
Meng, Qingju
Liu, Yibing
author_facet Zhang, Fan
Li, Xiaomin
Liu, Haisheng
Liu, Rongfeng
Zhou, Zhiguo
Zhang, Yi
Chen, Jingli
Tian, Ye
Pan, Chaohu
Meng, Qingju
Liu, Yibing
author_sort Zhang, Fan
collection PubMed
description The reason that immune checkpoint inhibitors have not been widely applied to pancreatic cancer treatment is probably because of low immunogenicity or dense stromal fibrosis. Recently, only pembrolizumab was recommended for DNA mismatch repair deficiency or high microsatellite instability by National Comprehensive Cancer Network guideline. Pancreatic ductal adenocarcinoma (PDAC) accounts for more than 90% of pancreatic cancer, with a poor overall survival rate, the value of immunotherapy for PDAC needs more research. Here, we report a 56-year-old man suffered from PDAC with liver metastasis after radical surgery. The next-generation sequencing result demonstrated that it had remarkably high tumor mutational burden (TMB) of 49.92 Muts/Mb and microsatellite stability. Sintilimab (anti-PD-1) monotherapy was continuously administrated after failure of combined chemotherapy in second line, achieving stable disease within 22 months and few immunotherapy-related adverse events. To our knowledge, this is the first time to report a good outcome achieving 22 months with progression-free survival after PDAC metastasis with monotherapy of sintilimab. TMB may serve as a potential efficacy-related predictor in PDAC patients with sintilimab and help physicians make optimum clinical strategy.
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spelling pubmed-94812882022-09-21 Unexpected favorable outcome to sintilimab monotherapy in a relapse pancreatic ductal adenocarcinoma patient with high tumor mutational burden: a case report Zhang, Fan Li, Xiaomin Liu, Haisheng Liu, Rongfeng Zhou, Zhiguo Zhang, Yi Chen, Jingli Tian, Ye Pan, Chaohu Meng, Qingju Liu, Yibing Anticancer Drugs Case Reports The reason that immune checkpoint inhibitors have not been widely applied to pancreatic cancer treatment is probably because of low immunogenicity or dense stromal fibrosis. Recently, only pembrolizumab was recommended for DNA mismatch repair deficiency or high microsatellite instability by National Comprehensive Cancer Network guideline. Pancreatic ductal adenocarcinoma (PDAC) accounts for more than 90% of pancreatic cancer, with a poor overall survival rate, the value of immunotherapy for PDAC needs more research. Here, we report a 56-year-old man suffered from PDAC with liver metastasis after radical surgery. The next-generation sequencing result demonstrated that it had remarkably high tumor mutational burden (TMB) of 49.92 Muts/Mb and microsatellite stability. Sintilimab (anti-PD-1) monotherapy was continuously administrated after failure of combined chemotherapy in second line, achieving stable disease within 22 months and few immunotherapy-related adverse events. To our knowledge, this is the first time to report a good outcome achieving 22 months with progression-free survival after PDAC metastasis with monotherapy of sintilimab. TMB may serve as a potential efficacy-related predictor in PDAC patients with sintilimab and help physicians make optimum clinical strategy. Lippincott Williams & Wilkins 2022-08-09 2022-10 /pmc/articles/PMC9481288/ /pubmed/35946538 http://dx.doi.org/10.1097/CAD.0000000000001334 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Case Reports
Zhang, Fan
Li, Xiaomin
Liu, Haisheng
Liu, Rongfeng
Zhou, Zhiguo
Zhang, Yi
Chen, Jingli
Tian, Ye
Pan, Chaohu
Meng, Qingju
Liu, Yibing
Unexpected favorable outcome to sintilimab monotherapy in a relapse pancreatic ductal adenocarcinoma patient with high tumor mutational burden: a case report
title Unexpected favorable outcome to sintilimab monotherapy in a relapse pancreatic ductal adenocarcinoma patient with high tumor mutational burden: a case report
title_full Unexpected favorable outcome to sintilimab monotherapy in a relapse pancreatic ductal adenocarcinoma patient with high tumor mutational burden: a case report
title_fullStr Unexpected favorable outcome to sintilimab monotherapy in a relapse pancreatic ductal adenocarcinoma patient with high tumor mutational burden: a case report
title_full_unstemmed Unexpected favorable outcome to sintilimab monotherapy in a relapse pancreatic ductal adenocarcinoma patient with high tumor mutational burden: a case report
title_short Unexpected favorable outcome to sintilimab monotherapy in a relapse pancreatic ductal adenocarcinoma patient with high tumor mutational burden: a case report
title_sort unexpected favorable outcome to sintilimab monotherapy in a relapse pancreatic ductal adenocarcinoma patient with high tumor mutational burden: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481288/
https://www.ncbi.nlm.nih.gov/pubmed/35946538
http://dx.doi.org/10.1097/CAD.0000000000001334
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