Achievement of complete response to nivolumab in a patient with advanced sarcomatoid hepatocellular carcinoma:A case report

BACKGROUND Sarcomatoid hepatocellular carcinoma(SHC)is a rare subtype of hepatocellular carcinoma(HCC),with a high recurrence rate after surgery.In addition to limited effective treatment for the advanced stage of SHC,the prognosis of patients with this malignancy is worse than that of patients with conventional HCC.CASE SUMMARY We present the case of a 54-year-old man with SHC who underwent radical segmental hepatectomy,which relapsed 4 mo after surgery due to lymphatic metastasis in the porta hepatis.Although a second surgery was performed,new metastasis developed in the mediastinal lymph nodes.Therefore,sorafenib and lenvatinib were sequentially administered as first-and second-line systemic therapies,respectively.However,progressive disease was confirmed based on a recurrent hepatic lesion and new metastatic lesion in the abdominal cavity.Percutaneous transhepatic cholangial drainage was performed to alleviate the biliary obstruction.Because the tumor was strongly positive for programmed death-ligand 1,the patient was started on nivolumab.Imaging studies revealed that after two cycles of immunotherapy,the metastatic lesions decreased to undetectable levels.CONCLUSION The patient experienced continuous complete remission for 8 mo.Immune checkpoint inhibitors are useful for the treatment of advanced SHC.

Successful treatment of stage ⅢB intrahepatic cholangiocarcinoma using neoadjuvant therapy with the PD-1 inhibitor camrelizumab:A case report

BACKGROUND The prognosis of intrahepatic cholangiocarcinoma(ICC) with lymph node metastasis is poor.The feasibility of surgery is not certain,which is a contraindication according to the National Comprehensive Cancer Network guidelines.The role of immunotherapy as a neoadjuvant therapy for ICC is not clear.We herein describe a case of ICC with lymph node metastasis that was successfully treated with neoadjuvant therapy.CASE SUMMARY A 60-year-old man with a liver tumor was admitted to our hospital.Enhanced computed tomography and magnetic resonance imaging revealed a spaceoccupying lesion in the right lobe of the liver.Multiple subfoci were found around the tumor,and the right posterior branch of the portal vein was invaded.Liver biopsy indicated poorly differentiated cholangiocytes.According to the American Joint Committee on Cancer disease stage classification,ICC with hilar lymph node metastasis(stage ⅢB) and para-aortic lymph node metastasis was suspected.A report showed that two patients with stage ⅢB ICC achieved a complete response(CR) 13 mo and 16 mo after chemotherapy with a PD-1 monoclonal antibody.After multidisciplinary consultation,the patient was given neoadjuvant therapy,surgical resection and lymph node dissection,and postoperative adjuvant therapy.After three rounds of PD-1 immunotherapy(camrelizumab) and two rounds of gemcitabine combined with cisplatin regimen chemotherapy,the tumor size was reduced.Therefore,a partial response was achieved.Exploratory laparotomy found that the lymph nodes of Group 16 were negative,and the tumor could be surgically removed.Therefore,the patient underwent right hemihepatectomy plus lymph node dissection.The patient received six rounds of chemotherapy and five rounds of PD-1 treatment postoperatively.After 8 mo of follow-up,no recurrence was found,and a CR was achieved.CONCLUSION Neoadjuvant therapy combined with surgical resection is useful for advanced-stage ICC.This is the first report of successful treatment of stage ⅢB ICC using neoadjuvant therapy with a PD-1 inhibitor.

Effect of dimethyl sulfone on anti-inflammatory and immune function in mice

Objective:To investigate the effects of dimethyl sulfone on serum cytokines and the ability of carbon clearance in mice induced by lipopolysaccharide (LPS), and explore the anti-inflammatory effect of dimethyl sulfone and its effect on immune function.Methods:The mice were randomly divided into six groups including control group, model group, dexamethasone positive group and dimethylsulfone high, medium and low dose groups. After being continuously administrated for 7 d, the mice were injected with LPS intraperitoneally. The IL -17F, IL-22, IL-23 and TNF-α of serum were texted, and the spleen, thymus coefficient and the ability of carbon monocyte-macrophage carbon clearance in each group were calculate, respectively.Results: Compared with the model group, dimethyl sulfone group could significantly reduce the secretion of proinflammatory cytokines IL-17F and TNF-α, enhance the expression of anti-inflammatory factor IL-22 and significantly increase the phagocytosis rate of macrophages.Conclusion: Dimethyl sulfone has obvious anti-inflammatory effect on LPS-induced inflammatory mice and enhances immune function in mice, and it has no obvious inhibitory effect on immune system.

Progress of tumor metabolites detection in urine

Objective: Urine is the end-products of the body, which reflects the functional State and health level of the body. By testing the urine, we can analyze and judge the body's State of health and find a noninvasive method for the detection of disease markers. In the case of lacking specific method to cure cancer, it will help improve cancer patients' survival and cure rates if malignant tumors are early screened and discovered, This article is aimed to summarize and review of small molecule metabolism of tumor markers in the urine study currently.