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Pathological pseudoprogression to anti-PD-1 inhibitor in metastatic periampullary carcinoma: Case report
Junhui Wang1, Yan Wang1, Xiaoling Che2
1Department of Radiation Oncology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, RD. Minjiang, Dist. Kecheng. Quzhou, Zhejiang, China.
Rationale:
Pseudoprogression has been deemed as a rare clinical phenomenon during the treatment of immune checkpoint inhibitors in patients with advanced cancers, especially in periampullary carcinoma, however, leaving potential molecular mechanism remain unknown.
Patient Concerns:
Regular examination after radical pancreaticoduodenectomy because of periampullary carcinoma.
Diagnoses:
Recurrent periampullary carcinoma with metastasis in liver.
Interventions:
Regimens of XELOX (oxaliplatin at a dose of 130 mg/m2, day 1 and oral capecitabine at a dose of 1000 mg/m2 twice a day, day 1-14, every 21 days), and tislelizumab at a dose of 200 mg, day 1, per 21 days, was prescribed as palliative treatment.
Outcomes:
Pseudoprogression and symptom of hair and mustache repigmentation were also observed, which resulted in partial response finally.
Lessons:
Results of the present case suggested that pseudoprogression, along with hair and mustache repigmentation, possibly caused by anti-PD-1 inhibitors, may also happen in patients with periampullary carcinoma, which should be paid attention to. The potential mechanism should be further investigated.
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