Successful Immune Checkpoint Inhibitor Rechallenge After Sintilimab-Induced Pancreatitis: A Case Report

Hepatocellular carcinoma (HCC) is the fourth most prevalent and the second most lethal cancer in China. Immune checkpoint inhibitors (ICIs) have dramatically improved treatment outcomes for advanced HCC. However, ICIs can also cause immune-related adverse events (irAEs), including the rare occurrence of ICI-related pancreatitis (ICIPI). After successful treatment of ICI-related pancreatitis, further research is needed to determine whether continuation of ICI therapy is appropriate for the patient. Currently, the clinical feasibility of resuming ICI therapy following complete resolution of ICIPI has not been definitively established. We report A 28-year-old patient diagnosed as unresectable HCC was treated with sintinilab, a programmed cell death-1 (PD-1) inhibitor, but he started appearing abdominal pain and was diagnosed with ICIPI. Following complete resolution of pancreatitis, immunotherapy was resumed with an alternative PD-1 inhibitor, tislelizumab. Ultimately achieving tumor partial response. ICIPI is a rare clinical event, and there is no unified management approach. In this case, after immune re-challenge, it not only prevented recurrence of immune ICIPI but also sustained a durable tumor partial response throughout the longitudinal follow-up period. This provides a practical treatment strategy for managing ICI-related adverse events in clinical practice.