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Penpulimab in an adolescent patient with pancreatic neuroendocrine carcinoma with liver metastasis: A case report and

Yafen Li1,2, Jing Zhang3, Jie Zheng3

  • 1Department of Clinical Pharmacy, Wanbei Coal and Electricity Group General Hospital, Suzhou, Anhui, China.

Medicine
|June 9, 2025
PubMed
Summary
This summary is machine-generated.

This case study shows that immunotherapy and antiangiogenic combinations can effectively treat advanced pancreatic neuroendocrine carcinoma (PNEC) in young patients. Programmed death-1 ligand-positive PNEC may respond to these novel approaches when chemotherapy is not an option.

Keywords:
anlotinibcase reportimmunotherapypancreatic neuroendocrine carcinomapenpulimab

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Area of Science:

  • Oncology
  • Immunotherapy
  • Medical Case Study

Background:

  • Pancreatic neuroendocrine carcinoma (PNEC) is a rare, aggressive cancer with poor prognosis, especially in young patients.
  • Metastatic PNEC presents limited therapeutic options, particularly for chemotherapy-ineligible individuals.
  • Optimal management strategies for advanced PNEC remain undefined.

Purpose of the Study:

  • To report a case of advanced pancreatic neuroendocrine carcinoma in a young patient.
  • To evaluate the efficacy of immunotherapy and antiangiogenic combination therapy in a chemotherapy-ineligible patient.
  • To highlight potential treatment alternatives for aggressive PNEC.

Main Methods:

  • A case report of an 18-year-old male with metastatic PNEC presenting with weight loss and abdominal distension.
  • Immunohistochemistry revealed programmed death-1 ligand positivity.
  • Treatment involved penpulimab (anti-programmed death-1) with anlotinib, later switched to penpulimab with sorafenib after progression.

Main Results:

  • The initial combination therapy achieved 13 months of progression-free survival, indicating durable disease control.
  • The patient experienced acquired resistance but tolerated treatment without severe toxicity.
  • The patient remained alive at the July 2024 follow-up.

Conclusions:

  • Programmed death-1 ligand-positive PNEC may respond to immunotherapy/antiangiogenic combinations.
  • These combinations offer viable alternatives for chemotherapy-ineligible patients with advanced PNEC.
  • Young patients with aggressive PNEC require tailored treatment strategies due to being an understudied population.