Efficacy of dual checkpoint inhibitors in a patient with a mixed hepatocellular cholangiocarcinoma

BMJ Case Rep. 2024 May 2;17(5):e255003. doi: 10.1136/bcr-2023-255003.

Abstract

A woman in her 60s was diagnosed with a metastatic, unresectable rare histological type of liver cancer; combined hepatocellular cholangiocarcinoma. She had palliative chemotherapy, initially with gemcitabine and cisplatin, and then with oxaliplatin, L-folinic acid and fluorouracil. Both treatment strategies demonstrated disease progression, and somatic mutation profiling revealed no actionable mutations. The patient was started on immuno-oncology (IO) with nivolumab and ipilimumab, followed by maintenance nivolumab. She has achieved a sustained ongoing partial response since the start of this therapy for at least 12 months. The outcome in this patient is in keeping with the growing evidence of the role that IO agents have in metastatic biliary tract cancer and also serves to highlight their importance in mixed histology liver tumours.

Keywords: Chemotherapy; Hepatic cancer.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bile Duct Neoplasms* / drug therapy
  • Bile Duct Neoplasms* / pathology
  • Carcinoma, Hepatocellular* / drug therapy
  • Carcinoma, Hepatocellular* / pathology
  • Cholangiocarcinoma* / drug therapy
  • Female
  • Humans
  • Immune Checkpoint Inhibitors* / therapeutic use
  • Ipilimumab / therapeutic use
  • Liver Neoplasms* / drug therapy
  • Liver Neoplasms* / pathology
  • Middle Aged
  • Nivolumab* / therapeutic use
  • Treatment Outcome

Substances

  • Immune Checkpoint Inhibitors
  • Nivolumab
  • Ipilimumab