Remarkable response to durvalumab and tremelimumab in a patient with hepatocellular carcinoma: a case report.

IF 0.9 Q4 GASTROENTEROLOGY & HEPATOLOGY

Clinical Journal of Gastroenterology Pub Date : 2025-09-26 DOI:10.1007/s12328-025-02223-x

Yosuke Osawa, Takayuki Akita, Yosuke Igarashi, Takaaki Ohtake

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引用次数: 0

Abstract

Aim: Predictive biomarkers for the efficacy of tremelimumab, a cytotoxic T lymphocyte antigen 4 (CTLA-4) inhibitor, in hepatocellular carcinoma (HCC) have not yet been identified.

Methods: We report a case of HCC in which switching from bevacizumab plus atezolizumab to tremelimumab plus durvalumab after disease progression resulted in marked tumor regression, accompanied by the development of immune-related adverse event hepatitis. To explore the underlying mechanism, we performed immunohistochemical analysis of CD80, CD86, CD31, and CD3 expression in HCC tissue samples from 15 patients, including the present case.

Results: Immunohistochemistry for PD-L1 showed no detectable expression in the tumor tissue. CD80 (a co-stimulatory molecule that binds to CD28 and CTLA-4) was strongly expressed in hepatoma cells, with higher levels compared to the other cases. In contrast, CD86 (another co-stimulatory molecule) was observed in non-parenchymal cells, with relatively low expressions in this case. Similarly, the expression levels of CD31 (microvessel density marker) and CD3 (T lymphocyte marker) were also low.

Conclusion: Strong expressions of CD80 may have contributed to the therapeutic response by shifting its binding from CTLA-4 to CD28 following CTLA-4 blockade, thereby promoting T cell activation. CD80 expression may serve as a predictive biomarker for the efficacy of CTLA-4 blockade therapy.

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duvalumab和tremelimumab治疗肝细胞癌的显著疗效：1例报告。

目的：细胞毒性T淋巴细胞抗原4 （CTLA-4）抑制剂tremelimumab治疗肝细胞癌（HCC）疗效的预测性生物标志物尚未确定。方法：我们报告了一例HCC病例，该病例在疾病进展后从贝伐单抗+阿特唑单抗切换到tremelimumab + durvalumab，导致肿瘤明显消退，并伴有免疫相关不良事件肝炎的发展。为了探索潜在的机制，我们对包括本病例在内的15例HCC患者的组织样本中CD80、CD86、CD31和CD3的表达进行了免疫组织化学分析。结果：PD-L1免疫组化在肿瘤组织中未见表达。CD80（一种结合CD28和CTLA-4的共刺激分子）在肝癌细胞中强烈表达，与其他病例相比表达水平更高。相比之下，CD86（另一种共刺激分子）在非实质细胞中观察到，在这种情况下表达相对较低。同样，CD31（微血管密度标记物）和CD3 （T淋巴细胞标记物）的表达水平也很低。结论：CD80的强表达可能在CTLA-4阻断后将其结合从CTLA-4转移到CD28，从而促进T细胞活化，从而促进了治疗反应。CD80表达可作为CTLA-4阻断治疗疗效的预测性生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

182

期刊介绍： The journal publishes Case Reports and Clinical Reviews on all aspects of the digestive tract, liver, biliary tract, and pancreas. Critical Case Reports that show originality or have educational implications for diagnosis and treatment are especially encouraged for submission. Personal reviews of clinical gastroenterology are also welcomed. The journal aims for quick publication of such critical Case Reports and Clinical Reviews.