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Anti-PD-1-based immunotherapy plus lenvatinib to treat advanced gallbladder cancer in the elderly: a case series and review of current literature

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Abstract

Background

Gallbladder cancer (GBC) is a rare malignant tumour of the bile duct. Due to the lack of typical clinical manifestations in the early stage, it is basically at an advanced stage when discovered. Radical resection remains the only curative therapy for patients with GBC. The resection rate is relatively low due to tumour invasion and metastasis, and the overall prognosis is poor. For most patients with unresectable lesions, chemotherapy has been the only recommended treatment for decades. Immunotherapy combined with TKIs (tyrosine kinase inhibitors) was proven to be effective in patients with hepatocellular carcinoma and cholangiocarcinoma. Some physicians have attempted to apply immunotherapy and TKIs combined with traditional chemotherapy in patients with advanced GBC. However, the outcomes were not clear because limited cases were reported.

Case presentation

We present a case series of four elderly patients with advanced GBC who received tislelizumab and lenvatinib combined with chemotherapy. All four patients responded to this treatment approach. Tumour responses were better in Patient 1 (TMB-H, MSS), Patient 2 (low TMB, MSS), and Patient 3 (low TMB, MSI-H) than in Patient 4 (low TMB, MSS), in whom metastasis occurred during the later stage of treatment.

Conclusion

The combination of tislelizumab and lenvatinib may be a promising treatment for patients with advanced GBC. The efficacy and safety need further confirmation.

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Funding

This work was supported by Natural Science Foundation of Zhejiang Province of China (no. LY19H160049).

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Authors and Affiliations

  1. Department of Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China

    Lantian Wang, Kezhong Tang, Xiawei Li & Wenjie Lu

Authors
  1. Lantian Wang
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  2. Kezhong Tang
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  3. Xiawei Li
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  4. Wenjie Lu
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Contributions

LW wrote the final manuscript. LW and WL performed the literature search. WL supervised the writing of the manuscript. KT and XL assisted in data collation. All authors participated in the care of the patients. All authors read and approved the final manuscript.

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Correspondence to Wenjie Lu.

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The authors declare that they have no competing interests.

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Wang, L., Tang, K., Li, X. et al. Anti-PD-1-based immunotherapy plus lenvatinib to treat advanced gallbladder cancer in the elderly: a case series and review of current literature. J Cancer Res Clin Oncol 149, 941–950 (2023). https://doi.org/10.1007/s00432-022-04126-7

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