Abstract YO5
Case summary
Complete Response in a Metastatic Gallbladder Adenocarcinoma Patient treated with Checkpoint Inhibitor/Chemotherapy Combination: A Case Report
Gallbladder Carcinoma is a rare malignancy with an overall incidence of 3 per 100,000. Prognosis is poor with a median overall survival of 11.7 months. This is attributed to aggressive tumor biology and advanced stages at diagnosis. The standard treatment of advanced gallbladder carcinoma is gemcitabine-based combination (gemcitabine-cisplatin). Recently, the superiority of adding the immune checkpoint inhibitor durvalumab to gem/cis was shown in the TOPAZ-1 trial. This case report highlights promising results on the use of durvalumab in advance gallbladder adenocarcinoma.
This is a case of a 64-year-old male who presented with abdominal pain. CT scan of the whole abdomen revealed cholecystolithiasis with cholecystitis, intraluminal hyperdense mass, consider gallbladder malignancy. Patient underwent exploratory laparotomy with frozen section biopsy which showed peritoneal fluid positive for adenocarcinoma. Intraoperatively, the gallbladder mass was unresectable, with a post operative diagnosis of Gallbladder Adenocarcinoma Stage IV. Subsequently, the patient was treated with Durvalumab (1500mg on day 1), Gemcitabine (1000mg/m2 on days 1 and 8) and cisplatin (25mg/m2 on days 1 and 8) every 3 weeks for 8 cycles.
After 8 cycles of systemic chemotherapy, a follow-up CT scan revealed complete regression of the intraluminal gallbladder mass. PET/CT scan also showed no evidence of hypermetabolic recurrent and metastatic disease. Patient underwent resection of the gallbladder mass with pathologic findings of negative for residual tumor cells, chronic cholecystitis with mucosal erosion and chemotherapy induced histologic changes.
This case report highlights the rare but possible complete pathologic response with the use of immune checkpoint inhibitor durvalumab and gemcitabine/cisplatin combination in advanced gallbladder adenocarcinoma. This is consistent with results of the TOPAZ1 trial demonstrating promising efficacy and improved outcomes with checkpoint inhibitors.
Clinical trial identification
Editorial acknowledgement
Resources from the same session
409P - Tertiary lymphoid structures are scarce but associated with BCR clonal expansion, B cell activity and checkpoint inhibitor response in advanced osteosarcoma
Presenter: Qiyuan Bao
Session: Poster viewing 06
410P - The incidence and risk factors of kidney injury in patients receiving immune checkpoint inhibitors: A retrospective observational cohort study
Presenter: Thanawat Suksomboon
Session: Poster viewing 06
411P - Cost-effective analysis of the various cancer screening methods in the community: Pooled analysis of camps of 5 years from 2017-to 2022
Presenter: Suresh Attili
Session: Poster viewing 06
412P - Substance-P in the blood is related with the efficacy of aprepitant for targeted drug-induced refractory pruritus in Chinese malignancy population
Presenter: Fang Gao
Session: Poster viewing 06
413P - Association of concomitant medications on survival outcomes in cancer patients treated with immune checkpoint inhibitors: Analysis of health insurance review and assessment database
Presenter: Soojung Hong
Session: Poster viewing 06
414P - Lessons learnt from clinico-genomic profiling of families with Li Fraumeni Syndrome: The largest case series from the Indian setting
Presenter: Ghazal Tansir
Session: Poster viewing 06
415P - Small cell lung cancer: Epidemiological patterns and mutational profile in the United States
Presenter: Abdallah Allam
Session: Poster viewing 06
416P - Survival outcomes predicted by irAEs on 18F-FDG-PET in response to PD-1 antibody therapy in metastatic melanoma
Presenter: Sarah Lewis
Session: Poster viewing 06
417P - The activity and safety of anlotinib for patients with recurrent malignant glioma: A single-center, retrospective study
Presenter: Xudong Sun
Session: Poster viewing 06
418P - Mutational landscape of non-small cell lung cancer in the United States
Presenter: Mostafa Elsayed
Session: Poster viewing 06