ArticleFrontiers in immunology2024
Case report: Complete response in TMB-H advanced uterine clear cell carcinoma: a case analysis of paclitaxel albumin-bound combined with PD-1/CTLA-4 bispecific antibody.
Article in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Uterine clear cell carcinoma (UCCC) is a rare and aggressive subtype of endometrial cancer, often presenting at an advanced stage with poor prognosis. Treatment options for advanced or recurrent UCCC are currently limited, especially after platinum-based chemotherapy has failed. Case presentation: We present the case of a 49-year-old female diagnosed with stage IV uterine clear cell carcinoma. The patient had a history of atrial fibrillation and initially received several surgical interventions and platinum-based chemotherapy, but these treatments resulted in poor outcomes and rapid tumor progression. Genetic testing showed a high tumor mutation burden (TMB-H, 42.24 mutations/Mb) with stable microsatellites and a suspected harmful mutation in the PMS2 gene. After conventional therapies failed, the patient received a combination treatment of cadonilimab (375 mg) and albumin-bound paclitaxel (380 mg) for six cycles. This was followed by cadonilimab monotherapy for maintenance. This treatment regimen led to a complete response (CR), with no detectable abdominal fluid or enlarged lymph nodes by January 4, 2023. The CR status was maintained during a follow-up on April 07, 2024. The adverse effects included severe myelosuppression, mild skin reactions, hypothyroidism, and Grade 3 hyperglycemia, all of which were managed symptomatically. Conclusion: This case illustrates how effective AK104/Cadonilimab (a PD-1/CTLA-4 bispecific) can be when combined with albumin-bound paclitaxel for treating advanced UCCC, especially in patients who have not responded to standard therapies. The patient's complete and lasting response shows the potential of PD-1/CTLA-4 bispecific immunotherapy. This suggests that cadonilimab could provide important clinical benefits for patients with advanced or recurrent UCCC.
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