4.6 Article

Multi-targeted tyrosine kinase inhibitor reverses resistance to immunotherapy in hepatic sarcomatoid carcinoma

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SPRINGER
DOI: 10.1007/s00432-023-05491-7

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Hepatic sarcomatoid carcinoma; Liver sarcomatoid carcinoma; Antiangiogenic therapy; Tyrosine kinase inhibitors; Immunotherapy; Efficacy

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Hepatic sarcomatoid carcinoma (HSC) is an aggressive liver cancer with poor prognosis. This case report describes a 60-year-old patient diagnosed with HSC, who developed multiple metastases after surgery. The patient received monotherapy with sintilimab for 12 months due to high expression of PD-1, followed by a combination treatment with anlotinib and sintilimab which resulted in 11 months of effective therapeutic response.
Hepatic sarcomatoid carcinoma (HSC) is characterized by its aggressive behavior and poor prognosis. As of now, no universally endorsed standard therapeutic approaches for HSC have been established. Herein, we describe the case of a 60-year-old individual diagnosed with HSC, subsequently presenting with multiple metastases postoperatively. Owing to the pronounced expression of programmed cell death protein 1 (PD-1), the individual was subjected to monotherapy utilizing sintilimab for a duration spanning 12 months. Following this regimen, a synergistic treatment approach comprising both anlotinib and sintilimab was instituted, culminating in an ensuing 11 months of efficacious therapeutic response. Throughout the course of treatment, the patient's quality of life remained satisfactory. This particular therapeutic strategy not merely reinforces the efficacy of PD-1 inhibitors in the realm of HSC management, but more pivotally, suggests that tyrosine kinase inhibitors (TKIs) might counteract resistance to PD-1 antagonists, thus offering a potentially augmented treatment paradigm for HSC.

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