PD-L1 for gallbladder cancer: case report

Abstract

The clinical outcome of the advanced biliary tract cancer (BTC) is unfavorable, and the mortality rate is high. With local advance and metastasis, the median survival time is less than 1 year. But this patient survived 14 months with no signs of progress under treatment in our hospital. And the patient situation is stable recently. This case report can provide a treatment template for clinicians. This patient was appeared dull pain in the upper abdomen, occasionally poor defaecating. After a series of medical tests, the patient was diagnosed with advanced gallbladder cancer (GBC). This patient received chemotherapy (oxaliplatin 220 mg d1 + capecitabine 1,500 mg bid d1–14; capecitabine 1,500 mg bid d1–14; gemcitabine 1.4 g d1, 8 + capecitabine 1,500 mg bid d1–14) combined with immunotherapy (pembrolizumab 200 mg). The patient is still alive.. And there were no signs of progress. The researches on the treatment of GBC are rare, and only standard first-line treatment, lack of second-line treatment of GBC. This patient of advanced GBC received standard first-line treatment (oxaliplatin 220 mg d1 + capecitabine 1,500 mg bid d1–14; capecitabine 1,500 mg bid d1–14; gemcitabine 1.4 g d1, 8 + capecitabine 1,500 mg bid d1–14) combined with immunotherapy (pembrolizumab 200 mg), the effect is fine and is expected to contribute to the treatment of BTC.

Programmed Death Ligand-1 (PD-L1) Is an Independent Negative Prognosticator in Western-World Gallbladder Cancer

“…Additional evidence comes from single case reports: Kong et al reported a significant response after combined radio- and immunotherapy with complete resolution of metastases in retroperitoneal lymph nodes and lungs in a patient with exceptionally high PD-L1 expression in 50% of the tumor cells [ 39 ]. Comparably favorable results were also observed by Li et al in a patient with metastatic GBC and 10% tumoral PD-L1 expression, being still alive with controlled disease 14 months after diagnosis upon combined chemotherapy and pembrolizumab administration [ 40 ]. Though the predictive value of PD-L1 expression in GBC is still controversial, these studies suggest tumoral PD-L1 expression to serve as a potentially useful biomarker in GBC immunotherapy.…”