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BackgroundWith significant advances in the diagnostic tools and treatment modalities of cancer, the incidence of multiple primary malignancies (MPMs) has increased in the last decades. The therapeutic option changed with the arising of immune checkpoint inhibitors (ICIs), which have improved the survival of a broad spectrum of tumors. However, little information is available when it comes to the efficacy, resistance, and underlying mechanisms of ICIs.Case PresentationA 67-year-old woman was diagnosed with pulmonary sarcomatoid carcinoma (PSC) with a history of hepatocellular carcinoma (HCC) and viral hepatitis B. Following the lack of response to systemic chemotherapy, she was treated with camrelizumab, an anti-programmed cell death protein 1 monoclonal antibody, in combination with chemotherapy, and a partial response was obtained both in PSC and HCC. After a course of 9-month treatment, the PSC lesion shrank still, while HCC was evaluated as a progressive disease with an increase in the diameter of liver neoplasm, elevated alpha-fetoprotein, and enlarged abdominal lymph nodes. Then, with the addition of radiotherapy for abdominal metastasis, the lung lesion was continuously shrinking. In the meantime, the liver neoplasm and abdominal lymph nodes showed no significant enlargement.ConclusionCamrelizumab combination therapy could consistently benefit the MPM patients with PSC and HCC, which may be a promising option for patients with MPMs.

Protonation/deprotonation is the well-recognized mass spectrometric mechanism in matrix-assisted laser desorption ionization of organic molecules but not for metal ions with different oxidation states. We describe herein a soft evaporation and ionization technique for metal ions based on iodination/de-iodination in metal–iodide cluster ionization (MICI). It is not only able to determine identities and oxidation states of metal ions but also reveal spatial distributions and isotope ratios in response to physiological or environmental changes. A long chain alcohol 1-tetradecanol with no functional groups that can absorb laser irradiation was used to cover and prevent samples from direct laser ablation. Upon the irradiation of the third harmonic Nd3+:YAG (355 nm, 3 ns), iohexol containing three covalently bonded iodine atoms instantly generates negative iodide ions that can quantitatively form clusters with at least 14 essential metal ions present in plants. The detection limits vary with different metal ions down to low fmol. MICI eliminates the atomization process that obscures metal charges in inductively coupled plasma mass spectrometry. Because only metal ions can be iodinated with iohexol, interferences from the abundant organic molecules of plants that are confronted by secondary ion mass spectrometry (SIMS) are also greatly decreased.

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