Case report: Preliminary response to tislelizumab plus S-1 in patients with metastatic gallbladder carcinoma: A report of five cases and a literature review

• Published in: Frontiers in immunology Vol. 14; p. 1144371
• Main Authors: Zhang, Yuzhu, Liu, Yuchen, Liu, Jing, Liu, Tiande, Xiong, Hu, Li, Wen, Fu, Xiaowei, Zhou, Fan, Liao, Shousheng, Fang, Lu, Liang, Bo
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 20.03.2023
• Subjects: Antibodies, Monoclonal, Humanized - therapeutic use; B7-H1 Antigen; Bile Duct Neoplasms - drug therapy; Bile Ducts, Intrahepatic; Cholangiocarcinoma - drug therapy; Gallbladder Neoplasms - drug therapy; GBC; Humans; Immunology; immunotharapy; PD-L1; S-1; tislelizumab; PD-L1; GBC; immunotharapy; tislelizumab; S-1
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2023.1144371

Gallbladder cancer (GBC) and cholangiocarcinoma are common cancers of the biliary system and are associated with a poor prognosis. Surgery and chemotherapy provide limited benefit to patients with advanced biliary tract carcinoma. Novel immunotherapies and molecularly targeted therapies are more effective options; however, few patients benefit and drug resistance is a concern. Here, we report five cases of advanced GBC with either high programmed death-ligand 1 (PD-L1) expression or a high tumor mutation burden (TMB-H). The patients were treated with a combination therapy of tislelizumab and S-1. The tumors were effectively controlled in most patients. One patient developed immune-related pneumonia (irP) during treatment, which resolved after hormone therapy, and the patient underwent surgery. Tislelizumab and S-1 were administered again after surgery; however, recurrent irP required discontinuation, and the tumor progressed after drug withdrawal. These cases demonstrate that combined therapy of anti-programmed cell death protein-1 (PD-1) antibodies and S-1 is a safe and effective regimen with few side effects for GBC patients, especially for sensitive populations (patients with TMB-H, microsatellite instability, deficient mismatch repair, or high expression of PD-L1). To our knowledge, this is the first time that tislelizumab in combination with S-1 has been used to treat patients with advanced GBC.