Complete response to pembrolizumab in advanced hepatocellular carcinoma with microsatellite instability

Clinical Journal of Gastroenterology Volume 13 Issue 5 Page 867-872 published_at 2020-10
アクセス数 : 492
ダウンロード数 : 119

今月のアクセス数 : 8
今月のダウンロード数 : 3
File
ClinJGastroenterol_13_867.pdf 1.43 MB 種類 : fulltext エンバーゴ : 2021-11-01
Title ( eng )
Complete response to pembrolizumab in advanced hepatocellular carcinoma with microsatellite instability
Creator
Ando Yuwa
Suehiro Yosuke
Yamaoka Kenji
Kosaka Yumi
Fuji Yasutomo
Uchikawa Shinsuke
Kodama Kenichiro
Nakahara Takashi
Ono Atsushi
Takahashi Shoichi
Source Title
Clinical Journal of Gastroenterology
Volume 13
Issue 5
Start Page 867
End Page 872
Abstract
Hepatocellular carcinoma (HCC) has limited systemic treatment options and a poor prognosis. The immune checkpoint inhibitor pembrolizumab was recently approved for the treatment of solid tumors with microsatellite instability (MSI). However, its clinical utility for the management of HCC remains to be clarified. Here, we present a case of unresectable HCC with MSI that showed an impressive response to pembrolizumab treatment. A 64-year-old man with chronic HCV infection was diagnosed with a large HCC. His severe liver dysfunction and poor performance status prevented any treatment option other than sorafenib. However, sorafenib failed after a few days due to the rapid progression of the tumor. Based on the finding of MSI in a biopsy specimen, immunotherapy using pembrolizumab was initiated. A dramatic improvement in his general condition and a reduction in tumor size were observed after the initiation of pembrolizumab treatment. Among a cohort of 50 consecutive patients with advanced HCC who were refractory to standard systemic therapy, MSI was found only in the present case. Immune checkpoint blockade therapy induced prominent anti-tumor effects in HCC with MSI. Screening for defects in DNA mismatch repair function may be warranted in HCC patients despite the low frequency of MSI.
Keywords
Hepatocellular carcinoma
Mismatch repair deficiency
MSI-high
Immune checkpoint blockade
PD-L1
Language
eng
Resource Type journal article
Publisher
Springer
Date of Issued 2020-10
Rights
This is a post-peer-review, pre-copyedit version of an article published in Clinical Journal of Gastroenterology. The final authenticated version is available online at: https://doi.org/10.1007/s12328-020-01099-3
This is not the published version. Please cite only the published version. この論文は出版社版ではありません。引用の際には出版社版をご確認、ご利用ください。
Publish Type Author’s Original
Access Rights open access
Source Identifier
[ISSN] 1865-7257
[ISSN] 1865-7265
[DOI] 10.1007/s12328-020-01099-3
[PMID] 32020539
[DOI] https://doi.org/10.1007/s12328-020-01099-3
Remark Post-print version/PDF may be used in an institutional repository after an embargo period of 12 months.