Effective treatment of gallbladder neuroendocrine carcinoma with nivolumab

Area of Science:

• Oncology
• Immunotherapy
• Gastroenterology

Background:

• Neuroendocrine neoplasms (NENs) are rare tumors.
• Gallbladder NENs (GB-NENs) are particularly uncommon.
• Metastatic disease presents significant treatment challenges.

Observation:

• An 89-year-old patient diagnosed with GB-NENs and lung cancer metastasis was treated with nivolumab monotherapy.
• The patient exhibited a positive response to nivolumab, with observed tumor shrinkage.
• Following initial treatment, the patient underwent surgery and adjuvant nivolumab therapy.

Findings:

• Nivolumab monotherapy demonstrated efficacy in reducing tumor burden for this patient.
• Surgical intervention combined with adjuvant nivolumab was effective.
• Treatment success was achieved despite low programmed death-ligand 1 (PD-L1) expression, suggesting potential efficacy beyond PD-L1 status.

Implications:

• This case highlights the potential of nivolumab in treating advanced GB-NENs with lung metastasis.
• The findings suggest that PD-L1 expression may not be the sole determinant of response to nivolumab in these rare cancers.
• Further research into immunotherapy for GB-NENs is warranted, exploring efficacy in diverse patient populations and PD-L1 expression levels.