Department of Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2023 Oct 8;52(5):578-582. doi: 10.3724/zdxbyxb-2023-0258.
A 68-year-old male was admitted due to fatigue and poor appetite and diagnosed pathologically as pancreatic adenocarcinoma with liver metastasis. The tumor marker carbohydrate antigen 199 (CA199) level was 2003.4 U/mL. The patient received two cycles of modified FOLFIRINOX plus immune checkpoint inhibitor (penpulimab). However, the tumor did not shrink and CA199 level was even higher. Anlotinib was added from the 3rd cycle, and the size of primary tumor and metastatic lesions were significantly reduced. Laparoscopic distal pancreatectomy and splenectomy as well as liver metastasis resection was performed. Three cycles of combined therapy were adopted after surgery followed by maintenance therapy with anlotinib plus penpulimab. There was no evidence of tumor recurrence during the follow-up (nearly 19 months since diagnosis).
一位 68 岁男性因疲劳和食欲不振入院，经病理诊断为胰腺腺癌伴肝转移。肿瘤标志物糖类抗原 199（CA199）水平为 2003.4 U/mL。患者接受了两周期改良 FOLFIRINOX 联合免疫检查点抑制剂（信迪利单抗）治疗，但肿瘤未缩小，CA199 水平甚至更高。从第 3 周期开始加用安罗替尼，原发肿瘤和转移病灶明显缩小。随后进行了腹腔镜胰体尾切除术和脾切除术以及肝转移灶切除术。术后采用联合治疗（安罗替尼+信迪利单抗）三个周期，然后进行维持治疗。随访期间无肿瘤复发证据（诊断后近 19 个月）。
