Prolonged Response to Anti–PD-1 Antibody Therapy in Chemotherapy-Refractory Cholangiocarcinoma With High Tumor Mutational Burden

Authors: Olumide Gbolahan MBBS a , Neda Hashemi-Sadraei MBBS b and Bert O’Neil MD c
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  • a University of Alabama at Birmingham School of Medicine, Birmingham, Alabama;
  • b University of New Mexico School of Medicine, Albuquerque, New Mexico; and
  • c Indiana University School of Medicine, Indianapolis, Indiana.
Volume/Issue:
Volume 17: Issue 6
Online Publication Date:
Jun 2019
DOI:
https://doi.org/10.6004/jnccn.2019.7304
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Management of advanced intrahepatic cholangiocarcinoma (iCCA) is challenging and overall survival is poor. Progress in the development of new therapeutic options for metastatic cholangiocarcinoma (CCA) has been slow; hence, to date, there are no approved second-line agents in this setting. Although the development of immune checkpoint inhibitors has significantly improved overall survival in a variety of malignancies, there has not been a clinically important impact in CCA. This report presents a 66-year-old patient with chemotherapy-refractory iCCA who experienced a prolonged response to immunotherapy. Tumor genome profiling revealed a high tumor mutation burden of 17 mutations per megabase in the absence of microsatellite instability. He was started on immunotherapy with nivolumab and has experienced an ongoing response for 16 months without clinical symptoms and only minimal radiologic disease.

Submitted August 9, 2018; accepted for publication March 29, 2019.

Disclosures: The authors have disclosed that they have no financial interests, arrangements, or affiliations with the manufacturers of any products discussed in this article or their competitors.

Correspondence: Olumide Gbolahan, MBBS, University of Alabama at Birmingham School of Medicine, NP2540J, 1802 Sixth Avenue South, Birmingham, AL 35233. Email: ogbolahan@uabmc.edu
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Copyright:
Copyright © 2019 by the National Comprehensive Cancer Network 2019
Page Numbers:
644–648
Article Category:
Other
Received:
09 Aug 2018
Accepted:
29 Mar 2019
Print Publication Date:
01 Jun 2019
Online Publication Date:
Jun 2019
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