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病例报告:克服胰腺癌伴肝转移的挑战:TACE、消融和免疫治疗的个体化治疗之旅。

Case Report: Overcoming challenges in pancreatic cancer with liver metastases: a personalized therapeutic odyssey of TACE, ablation, and immunotherapy.

机构信息

Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

Front Immunol. 2023 Oct 11;14:1275782. doi: 10.3389/fimmu.2023.1275782. eCollection 2023.

Abstract

Pancreatic cancer represents a malignant neoplasm originating from pancreatic cells. The optimal approach to cancer treatment remains uncertain, lacking a definitive consensus. Here, we present a compelling case of a 49-year-old female with pancreatic head cancer with liver metastases, as identified by CT and confirmed by biopsy. PET-CT indicated widespread metastatic involvement. TACE therapy with gemcitabine and cisplatin was initiated, yielding a stable disease response. The patient's high PD-L1 expression prompted TACE-PD-1 monoclonal antibody combination therapy. Subsequent treatments, including ablation, sustained PD-1 immunotherapy, and consolidation TACE, culminated in a complete response, as evidenced by imaging and tumor marker dynamics. Our case underscores the potential of multifaceted strategies in managing aggressive pancreatic cancer.

摘要

胰腺癌是一种起源于胰腺细胞的恶性肿瘤。癌症的最佳治疗方法仍不确定,缺乏明确的共识。在这里,我们报告了一例 49 岁女性的病例,她患有胰头癌伴肝转移,通过 CT 和活检证实。PET-CT 显示广泛的转移受累。用吉西他滨和顺铂开始 TACE 治疗,获得了稳定的疾病反应。患者的高 PD-L1 表达促使进行 TACE-PD-1 单克隆抗体联合治疗。随后的治疗,包括消融、持续的 PD-1 免疫治疗和巩固 TACE,最终通过影像学和肿瘤标志物动态评估达到完全缓解。我们的病例强调了在治疗侵袭性胰腺癌中采用多方面策略的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9c1/10598638/f87e2cc5b9d9/fimmu-14-1275782-g001.jpg

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