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Case report: Local cryoablation combined with pembrolizumab to eliminate lung metastases from ovarian clear cell carcinoma

Ovarian clear cell carcinoma has a high recurrence rate with poor prognosis and is generally not sensitive to conventional platinum-based chemotherapy. Its less frequent occurrence of mutations such as BRCA limited the targeted therapies. Immunotherapy is not currently recommended as a first-line ag...

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Autores principales: Meng, Liangliang, Zhang, Zhongliang, Zhang, Xiao, Zhang, Xiaobo, Wei, Yingtian, Wu, Bin, Xue, Xiaodong, Zhang, Xin, He, Xiaofeng, Xiao, Yueyong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684319/
https://www.ncbi.nlm.nih.gov/pubmed/36439155
http://dx.doi.org/10.3389/fimmu.2022.1006500
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author Meng, Liangliang
Zhang, Zhongliang
Zhang, Xiao
Zhang, Xiaobo
Wei, Yingtian
Wu, Bin
Xue, Xiaodong
Zhang, Xin
He, Xiaofeng
Xiao, Yueyong
author_facet Meng, Liangliang
Zhang, Zhongliang
Zhang, Xiao
Zhang, Xiaobo
Wei, Yingtian
Wu, Bin
Xue, Xiaodong
Zhang, Xin
He, Xiaofeng
Xiao, Yueyong
author_sort Meng, Liangliang
collection PubMed
description Ovarian clear cell carcinoma has a high recurrence rate with poor prognosis and is generally not sensitive to conventional platinum-based chemotherapy. Its less frequent occurrence of mutations such as BRCA limited the targeted therapies. Immunotherapy is not currently recommended as a first-line agent for ovarian cancer, and most patients are not yet able to benefit from it. Cryoablation can be used to treat solid systemic tumors, including ovarian cancer metastases, and can produce a limited anti-tumor immune response. The anti-tumor effects of cryoablation combined with immunotherapy have not been adequately confirmed. This study reports a case of a patient with ovarian clear cell carcinoma who underwent conventional adjuvant chemotherapy after initially surgical resection of the tumor. Unfortunately, cancer recurred and metastasized to the abdominal wall. After a series of painful chemotherapy and a second surgery, the cancer was still not effectively controlled, and the patient developed extensive metastases in the lung. The patient’s PD-L1 expression level also did not support solo immunotherapy. We pioneered the use of cryoablation to first eradicate the most significant lesion in the upper lobe of the left lung and then combined it with the PD-L1 inhibitor pembrolizumab to treat the patient with immunotherapy, which resulted in the complete eradication of the other multiple metastases in the lung and saved the patient’s life. Although the precise mechanism of action has not yet been explored, we have reason to believe that the combination of cryoablation and immune checkpoint inhibitor has a powerful synergistic anti-tumor effect, which is yet to be confirmed by more basic research and clinical applications in the next step.
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spelling pubmed-96843192022-11-25 Case report: Local cryoablation combined with pembrolizumab to eliminate lung metastases from ovarian clear cell carcinoma Meng, Liangliang Zhang, Zhongliang Zhang, Xiao Zhang, Xiaobo Wei, Yingtian Wu, Bin Xue, Xiaodong Zhang, Xin He, Xiaofeng Xiao, Yueyong Front Immunol Immunology Ovarian clear cell carcinoma has a high recurrence rate with poor prognosis and is generally not sensitive to conventional platinum-based chemotherapy. Its less frequent occurrence of mutations such as BRCA limited the targeted therapies. Immunotherapy is not currently recommended as a first-line agent for ovarian cancer, and most patients are not yet able to benefit from it. Cryoablation can be used to treat solid systemic tumors, including ovarian cancer metastases, and can produce a limited anti-tumor immune response. The anti-tumor effects of cryoablation combined with immunotherapy have not been adequately confirmed. This study reports a case of a patient with ovarian clear cell carcinoma who underwent conventional adjuvant chemotherapy after initially surgical resection of the tumor. Unfortunately, cancer recurred and metastasized to the abdominal wall. After a series of painful chemotherapy and a second surgery, the cancer was still not effectively controlled, and the patient developed extensive metastases in the lung. The patient’s PD-L1 expression level also did not support solo immunotherapy. We pioneered the use of cryoablation to first eradicate the most significant lesion in the upper lobe of the left lung and then combined it with the PD-L1 inhibitor pembrolizumab to treat the patient with immunotherapy, which resulted in the complete eradication of the other multiple metastases in the lung and saved the patient’s life. Although the precise mechanism of action has not yet been explored, we have reason to believe that the combination of cryoablation and immune checkpoint inhibitor has a powerful synergistic anti-tumor effect, which is yet to be confirmed by more basic research and clinical applications in the next step. Frontiers Media S.A. 2022-11-10 /pmc/articles/PMC9684319/ /pubmed/36439155 http://dx.doi.org/10.3389/fimmu.2022.1006500 Text en Copyright © 2022 Meng, Zhang, Zhang, Zhang, Wei, Wu, Xue, Zhang, He and Xiao https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Meng, Liangliang
Zhang, Zhongliang
Zhang, Xiao
Zhang, Xiaobo
Wei, Yingtian
Wu, Bin
Xue, Xiaodong
Zhang, Xin
He, Xiaofeng
Xiao, Yueyong
Case report: Local cryoablation combined with pembrolizumab to eliminate lung metastases from ovarian clear cell carcinoma
title Case report: Local cryoablation combined with pembrolizumab to eliminate lung metastases from ovarian clear cell carcinoma
title_full Case report: Local cryoablation combined with pembrolizumab to eliminate lung metastases from ovarian clear cell carcinoma
title_fullStr Case report: Local cryoablation combined with pembrolizumab to eliminate lung metastases from ovarian clear cell carcinoma
title_full_unstemmed Case report: Local cryoablation combined with pembrolizumab to eliminate lung metastases from ovarian clear cell carcinoma
title_short Case report: Local cryoablation combined with pembrolizumab to eliminate lung metastases from ovarian clear cell carcinoma
title_sort case report: local cryoablation combined with pembrolizumab to eliminate lung metastases from ovarian clear cell carcinoma
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684319/
https://www.ncbi.nlm.nih.gov/pubmed/36439155
http://dx.doi.org/10.3389/fimmu.2022.1006500
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