Pathological Complete Response to Liver Metastasis With Pembrolizumab in a Previously Treated Patient With Microsatellite Instability-high Colorectal Cancer.

IF 1.6 4区医学 Q4 ONCOLOGY Anticancer research Pub Date : 2024-09-01 DOI:10.21873/anticanres.17241

Ayumu Hosokawa, Hotaka Tamura, Akiko Ichihara, Naoya Imamura, Kengo Kai, Tsuyoshi Fukushima, Atsushi Nanashima, Yoshihiro Komohara

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Abstract

Background/aim: Immune checkpoint inhibitors are effective in treating microsatellite instability-high (MSI-H) metastatic colorectal cancer (CRC). Pathological complete response to immune checkpoint inhibitors for MSI-H metastatic CRC have been described in several reports. Liver metastasis is known to predict resistance to ani-programmed death 1 (PD-1)/PD-1 ligand 1 (PD-L1) therapy in several cancers, including CRC.

Case report: Herein, we report the case of a 23-year-old man with MSI-H colorectal liver metastasis who exhibited a pathological complete response to pembrolizumab following systemic chemotherapies. Pathological examination of the primary lesion revealed strong HLA-class I and HLA-DR expression in cancer cells. Elevated PD-L1 expression was observed in areas of increased CD8-postive T cell infiltration. Additional pathological study of regional lymph nodes showed increased PD-L1 and CD169 expression.

Conclusion: A detailed pathological examination revealed PD-L1 expression not only in the primary CRC lesion but also in regional lymph nodes. Recent studies have highlighted the significance of regional lymph nodes in anti-cancer immune responses. Therefore, pathological studies using resected lymph nodes might be beneficial for predicting the response of anti-PD-1/PD-L1 therapy.

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曾接受过治疗的微卫星不稳定性高结直肠癌患者使用 Pembrolizumab 治疗后对肝转移病理完全应答

背景/目的：免疫检查点抑制剂可有效治疗微卫星不稳定性高（MSI-H）的转移性结直肠癌（CRC）。已有多篇报道描述了免疫检查点抑制剂治疗 MSI-H 转移性结直肠癌的病理完全反应。肝转移可预测包括 CRC 在内的多种癌症对免疫程序死亡 1（PD-1）/PD-1 配体 1（PD-L1）疗法的耐药性：在此，我们报告了一例23岁男性MSI-H结直肠肝转移患者的病例，该患者在接受全身化疗后对pembrolizumab表现出病理完全应答。原发病灶的病理学检查显示，癌细胞中有较强的HLA-Ⅰ级和HLA-DR表达。在 CD8 阳性 T 细胞浸润增加的区域观察到 PD-L1 表达升高。对区域淋巴结的其他病理研究显示，PD-L1和CD169的表达也有所增加：结论：详细的病理检查显示，PD-L1不仅在原发性CRC病灶中表达，而且在区域淋巴结中也有表达。最近的研究强调了区域淋巴结在抗癌免疫反应中的重要性。因此，利用切除的淋巴结进行病理研究可能有助于预测抗PD-1/PD-L1疗法的反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.