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CASE REPORT article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1487227

Long-term response to a combination of immune checkpoint inhibitors as a single treatment for multiple synchronous cancers: A case study Authors

Provisionally accepted
NOUR GHAMMEM NOUR GHAMMEM HERVE BISCHOFF HERVE BISCHOFF PASCALE CHIAPPA PASCALE CHIAPPA Laura Somme Laura Somme FABIEN MOINARD-BUTOT FABIEN MOINARD-BUTOT *
  • Institut de Cancérologie Strasbourg Europe, Strasbourg, France

The final, formatted version of the article will be published soon.

    Introduction: Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by enhancing the antitumor immune response. This case describes an 80-year-old male with synchronous multiple primary malignancies (MPMs), including lung metastatic hepatocellular carcinoma (HCC), and non-small cell lung carcinoma (NSCLC), and brain metastatic urothelial carcinoma, who was treated with dual ICI therapy.The patient, with a history of diabetes, hypertension, dyslipidaemia, welldifferentiated neuroendocrine duodenal tumors and micronodular exogenous cirrhosis (Child-Pugh class A), presented with a non-invasive bladder carcinoma (pT1N0M0) resected endoscopically in December 2022. Incidentally discovered hepatic and pulmonary tumors were confirmed as primary HCC and squamous cell carcinoma of the lung (cT1bN0M0, PD-L1 expression 100%), respectively. Due to the rapid progression of pulmonary metastases secondary to HCC, dual ICI therapy (durvalumab and tremelimumab) was initiated, resulting in a partial response (>30%) according to RECISTv1.1 criteria in pulmonary and hepatic lesions. After one year of ICI therapy, cerebellar syndrome due to secondary brain lesions emerged, which was confirmed as urothelial metastases. Surgical resection of the symptomatic cerebral metastases was completed with cerebral radiotherapy, and ICIs were continued. The patient is still receiving dual ICIs.Discussion: This case highlights the crucial role of ICIs in treating MPMs. The patient's favourable response suggests the importance of PD-L1 expression as a predictive biomarker.This rare case showed dual ICI therapy efficacy across multiple malignancies. Effective multidisciplinary collaboration and biomarker evaluation are crucial for managing such complex cases.

    Keywords: Multiple primary malignancies, lung cancer, urothelial carcinoma, Hepatocellular Carcinoma, Immune checkpoint inhibitor

    Received: 27 Aug 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 GHAMMEM, BISCHOFF, CHIAPPA, Somme and MOINARD-BUTOT. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: FABIEN MOINARD-BUTOT, Institut de Cancérologie Strasbourg Europe, Strasbourg, France

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.