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ID 50461
creator
Ando, Yuwa
Suehiro, Yosuke
Yamaoka, Kenji
Kosaka, Yumi
Fuji, Yasutomo
Uchikawa, Shinsuke
Kodama, Kenichiro
Nakahara, Takashi
Ono, Atsushi
Takahashi, Shoichi
subject
Hepatocellular carcinoma
Mismatch repair deficiency
MSI-high
Immune checkpoint blockade
PD-L1
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.
journal title
Clinical Journal of Gastroenterology
volume
Volume 13
issue
Issue 5
start page
867
end page
872
date of issued
2020-10
publisher
Springer
issn
1865-7257
1865-7265
publisher doi
pubmed id
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
author
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。
relation url
department
Graduate School of Biomedical & Health Sciences
University Medical Hospital
Natural Science Center for Basic Research and Development
note
Post-print version/PDF may be used in an institutional repository after an embargo period of 12 months.