Department of Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
J Cancer Res Clin Oncol. 2023 Mar;149(3):941-950. doi: 10.1007/s00432-022-04126-7. Epub 2022 Jun 27.
Gallbladder cancer (GBC) is a rare malignant tumour of the bile duct. Due to the lack of typical clinical manifestations in the early stage, it is basically at an advanced stage when discovered. Radical resection remains the only curative therapy for patients with GBC. The resection rate is relatively low due to tumour invasion and metastasis, and the overall prognosis is poor. For most patients with unresectable lesions, chemotherapy has been the only recommended treatment for decades. Immunotherapy combined with TKIs (tyrosine kinase inhibitors) was proven to be effective in patients with hepatocellular carcinoma and cholangiocarcinoma. Some physicians have attempted to apply immunotherapy and TKIs combined with traditional chemotherapy in patients with advanced GBC. However, the outcomes were not clear because limited cases were reported.
We present a case series of four elderly patients with advanced GBC who received tislelizumab and lenvatinib combined with chemotherapy. All four patients responded to this treatment approach. Tumour responses were better in Patient 1 (TMB-H, MSS), Patient 2 (low TMB, MSS), and Patient 3 (low TMB, MSI-H) than in Patient 4 (low TMB, MSS), in whom metastasis occurred during the later stage of treatment.
The combination of tislelizumab and lenvatinib may be a promising treatment for patients with advanced GBC. The efficacy and safety need further confirmation.
胆囊癌（GBC）是一种罕见的胆管恶性肿瘤。由于早期缺乏典型的临床表现，发现时基本处于晚期。根治性切除术仍然是 GBC 患者唯一的治愈性治疗方法。由于肿瘤的侵袭和转移，切除率相对较低，总体预后较差。对于大多数不可切除病变的患者，化疗几十年来一直是唯一推荐的治疗方法。免疫疗法联合 TKI（酪氨酸激酶抑制剂）已被证明对肝细胞癌和胆管癌患者有效。一些医生试图在晚期 GBC 患者中应用免疫疗法和 TKI 联合传统化疗。然而，由于报道的病例有限，结果并不明确。
我们报告了四例接受替雷利珠单抗和仑伐替尼联合化疗的老年晚期 GBC 患者的病例系列。所有四名患者均对这种治疗方法有反应。1 号患者（TMB-H，MSS）、2 号患者（低 TMB，MSS）和 3 号患者（低 TMB，MSI-H）的肿瘤反应优于 4 号患者（低 TMB，MSS），后者在治疗后期发生转移。
替雷利珠单抗联合仑伐替尼可能是治疗晚期 GBC 患者的一种有前途的治疗方法。其疗效和安全性需要进一步证实。
