Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Clinical Medicine Research Center for Hepatic Surgery of Hubei Province, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Front Immunol. 2023 Oct 6;14:1274449. doi: 10.3389/fimmu.2023.1274449. eCollection 2023.
Combined immunotherapy has shown promising results in the treatment of advanced HCC, whereas the priority population that would respond to the combined immunotherapy is still elusive. In addition, HCC with asymptomatic hyperamylasemia was not reported previously.
An aged patient was diagnosed as HCC with BCLC stage C (bone metastasis). Notably, this patient showed asymptomatic hyperamylasemia. The patient was then enrolled in a trial evaluating combined immunotherapy of anti-PD-1 antibody sintilimab (IBI308) plus anti-CTLA-4 antibody (IBI310) in advanced HCC. After being treated with combined immunotherapy, this patient rapidly achieved complete response (CR) according to mRECIST criteria or immune partial response (iPR) according to iRECIST criteria and maintain the CR state for more than 12 months. Interestingly, serum levels of amylase and lipase in this patient were reduced after treatment.
We reported, for the first time, a case of metastatic HCC with asymptomatic hyperamylasemia, and suggested that HCC patients with asymptomatic hyperamylasemia may benefit from combined immunotherapy of anti-CTLA-4 and PD-1 antibodies.
联合免疫疗法在治疗晚期 HCC 方面显示出了有前景的结果，然而，对于哪些人群会对联合免疫疗法产生反应，目前仍难以确定。此外，以前没有报道过无症状高淀粉酶血症的 HCC。
一名老年患者被诊断为 BCLC 分期 C（骨转移）的 HCC。值得注意的是，该患者表现出无症状高淀粉酶血症。随后，该患者参加了一项评估抗 PD-1 抗体替雷利珠单抗（IBI308）联合抗 CTLA-4 抗体替西利珠单抗（IBI310）治疗晚期 HCC 的联合免疫疗法试验。接受联合免疫疗法治疗后，根据 mRECIST 标准，该患者迅速达到完全缓解（CR）或根据 iRECIST 标准达到免疫部分缓解（iPR），且持续 CR 状态超过 12 个月。有趣的是，该患者的淀粉酶和脂肪酶血清水平在治疗后降低。
我们首次报道了一例伴有无症状高淀粉酶血症的转移性 HCC 病例，并提示伴有无症状高淀粉酶血症的 HCC 患者可能从抗 CTLA-4 和 PD-1 抗体的联合免疫疗法中获益。
