Chen Yen-Hao, Huang Yu-Ting, Kuo Fang-Ying
Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan.
School of Medicine, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
Onco Targets Ther. 2024 Oct 29;17:857-861. doi: 10.2147/OTT.S483155. eCollection 2024.
Cholangiocarcinoma is a malignant tumor that affects the bile ducts and is usually aggressive with poor prognosis. The treatment of cholangiocarcinoma depends on the stage and location of the tumor as well as the patient's overall health status. Systemic therapy, such as chemotherapy using gemcitabine and cisplatin, is the first choice for patients with cholangiocarcinoma who were inoperable. After no response to first-line chemotherapy, second-line chemotherapy or targeted therapy focusing on signaling pathway inhibition are subsequent treatment. The present report described a case of cholangiocarcinoma involving bilateral lobes of liver. He received one cycle of chemotherapy with gemcitabine plus cisplatin and exhibited rapid progression. Next-generation sequencing was performed, and the results showed that MET amplification had a gene copy number of 68. After that, he underwent tepotinib and tumor shrinkage occurred. After a follow‑up period of 12 months, the treatment response was partial response, and the benefit of tepotinib is ongoing. The development of precision medicine has expanded the paradigm of targeted therapies to increasingly favorable options in the second line and beyond, and prolong overall survival. Detecting druggable mutations (mutations potentially amenable to treatment with) for identifying a landscape of therapeutic options is imperative for managing cholangiocarcinoma.
胆管癌是一种影响胆管的恶性肿瘤，通常具有侵袭性，预后较差。胆管癌的治疗取决于肿瘤的分期和位置以及患者的整体健康状况。全身治疗，如使用吉西他滨和顺铂的化疗，是无法手术的胆管癌患者的首选治疗方法。在一线化疗无反应后，二线化疗或针对信号通路抑制的靶向治疗是后续治疗方法。本报告描述了一例累及肝脏双侧叶的胆管癌病例。他接受了一个周期的吉西他滨加顺铂化疗，但病情迅速进展。进行了二代测序，结果显示MET扩增的基因拷贝数为68。之后，他接受了替泊替尼治疗，肿瘤出现缩小。经过12个月的随访，治疗反应为部分缓解，替泊替尼的疗效仍在持续。精准医学的发展将靶向治疗的模式扩展到了二线及以后越来越有利的选择，并延长了总生存期。检测可靶向治疗的突变（可能适合治疗的突变）以确定治疗方案对于胆管癌的管理至关重要。
