Treatment of Multiple Primary Malignancies With PD-1 Inhibitor Camrelizumab: A Case Report and Brief Literature Review

Abstract

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.

Clinicopathological features, prognostic factor analysis, and survival nomogram of patients with double primary cancers involving lung cancer

“…The advent of immune checkpoint inhibitors also offers new options for treating patients with DPCs involving lung cancer. There have been several case reports of successful combination therapy with immune checkpoint inhibitors for DPCs, including nabrituzumab, carrilizumab, pablizumab, and atelelizumab 32–35 . The combination of radiotherapy, chemotherapy, and low‐toxicity immune and targeted agents has shown promise in the individualized treatment of patients with inoperable DPCs 34,36 …”

“…There have been several case reports of successful combination therapy with immune checkpoint inhibitors for DPCs, including nabrituzumab, carrilizumab, pablizumab, and atelelizumab. [32][33][34][35] The combination of radiotherapy, chemotherapy, and low-toxicity immune and targeted agents has shown promise in the individualized treatment of patients with inoperable DPCs. 34,36 The development of MPCs is associated with various factors.…”

Synchronous double primary tumors of liver (small cell neuroendocrine carcinoma and hepatocellular carcinoma)：A case report

“…When simultaneous neoplasms are discovered, systematic therapy should be given according to the tumor with the worst prognosis. In this patient, the disease of small cell neuroendocrine carcinoma was under control, targeted hepatocellular carcinoma therapy was performed, HIAC and TACE combined with sorafenib was given to the patient, considered that Immune escapes is one of the most common pathological mechanism of various malignant tumors, and immunotherapy was effective to the both kinds of tumor (12)(13)(14), immunotherapy was given to control the disease, although the treatment was interrupted due to the COVID-19, but restart the immunotherapy, the patient was effective. By now the patient was in good condition without obvious symptom, the survival time was 11months.…”

Synchronous Double Primary Tumors of Liver (Small Cell Neuroendocrine Carcinoma and Hepatocellular carcinoma): A Case Report

“…8 When simultaneous neoplasms are discovered, systematic therapy should be given according to the tumor with the worst prognosis. In this patient, the disease of small cell neuroendocrine carcinoma was under control, targeted hepatocellular carcinoma therapy was performed, HIAC and TACE combined with sorafenib was given to the patient, considered that Immune escapes is one of the most common pathological mechanism of various malignant tumors, and immunotherapy was effective to the both kinds of tumor, [12][13][14] immunotherapy was given to control the disease, although the treatment was interrupted due to the COVID-19, but restart the immunotherapy, the patient was effective. By now the patient was in good condition without obvious symptom, the survival time was 16 months.…”