He YG, Zhang LY, Li J, Wang Z, Zhao CY, Zheng L, Huang XB. Conversion therapy in advanced perihilar cholangiocarcinoma based on patient-derived organoids: A case report. World J Gastrointest Oncol 2024; 16(10): 4274-4280 [PMID: 39473955 DOI: 10.4251/wjgo.v16.i10.4274]
Corresponding Author of This Article
Lu Zheng, MD, PhD, Chief Doctor, Department of Hepatobiliary, The Second Affiliated Hospital of Army Medical University, No. 83 Xinqiaozheng Street, Shapingbei District, Chongqing 400037, China. zhenglu@tmmu.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yong-Gang He, Jing Li, Zheng Wang, Chong-Yu Zhao, Lu Zheng, Xiao-Bing Huang, Department of Hepatobiliary, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
Ling-Yu Zhang, School of Clinical Oncology, Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, Fujian Province, China
Ling-Yu Zhang, Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou 350014, Fujian Province, China
Co-first authors: Yong-Gang He and Ling-Yu Zhang.
Co-corresponding authors: Lu Zheng and Xiao-Bing Huang.
Author contributions: He YG and Zhang LY were responsible for writing the manuscript; Li J, Wang Z, and Zhao CY were responsible for data acquisition and investigation; Zheng L and Huang XB reviewed the manuscript; All authors contributed to the study and approved the submitted version.
Supported bythe Chongqing Natural Science Foundation Project, No. CSTB2022NSCQ-MSX0172.
Informed consent statement: The patient provided the written informed consent to participate in this study. Written informed consent was obtained from the individual for the publication of any potentially identifiable images or data included in this article.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lu Zheng, MD, PhD, Chief Doctor, Department of Hepatobiliary, The Second Affiliated Hospital of Army Medical University, No. 83 Xinqiaozheng Street, Shapingbei District, Chongqing 400037, China. zhenglu@tmmu.edu.cn
Received: April 26, 2024 Revised: August 20, 2024 Accepted: August 28, 2024 Published online: October 15, 2024 Processing time: 152 Days and 21.5 Hours
Abstract
BACKGROUND
Patient-derived organoids (PDOs) have been demonstrated to predict the response to drugs in multiple cancer types. However, it remains unclear about its application in cholangiocarcinoma.
CASE SUMMARY
A 59-year-old woman was admitted to the hospital due to upper abdominal pain for over 8 months. According to relevant examinations, she was diagnosed as perihilar cholangiocarcinoma (pCCA) with intrahepatic metastasis and perihilar lymphatic metastasis. After multidisciplinary team discussion, percutaneous transhepatic cholangiodrainage was performed to relieve biliary obstruction, and puncture biopsy was conducted to confirm the pathological diagnosis. Transarterial chemoembolization with nab-paclitaxel was used in combination with toripalimab and lenvatinib, but the levels of tumor markers including alpha fetal protein, carcinoembryonic antigen, carbohydrate antigen 15-3 and cancer antigen 125 were still raised. The PDO for drug screening showed sensitive to gemcitabine and cisplatin. Accordingly, the chemotherapy regimen was adjusted to gemcitabine and cisplatin in combination with toripalimab and lenvatinib. After 4 cycles of treatment, the tumor was assessed resectable, and radical surgical resection was performed successfully. One year after surgery, the patient was still alive, and no recurrence or occurred.
CONCLUSION
PDOs for drug sensitivity contribute to screening effective chemotherapy drugs for advanced pCCA, promoting conversion therapy and improving the prognosis.
Core Tip: The patient-derived organoids (PDOs) have been demonstrated to predict the response to drugs in multiple cancer types. Here we first descried a patient with advanced perihilar cholangiocarcinoma (pCCA) who successfully underwent surgical resection after use of the PDO-guided gemcitabine and cisplatin in combination with toripalimab and lenvatinib and achieved good prognosis. For advanced pCCA patients, the PDO-based drug sensitivity testing contributes to screening effective chemotherapy drugs to promote the personalized treatment, which not only creates opportunities for surgical resection by lessening the tumor, but also offers a novel platform for improving the patient’s prognosis.
