Abstract:

Objective

To evaluate the safety and efficacy of radiotherapy combined with targeted neoadjuvant immunotherapy for intrahepatic cholangiocarcinoma (ICC).

Methods

Clinical data of 6 ICC patients who received radiotherapy combined with targeted immunotherapy in Beijing Tsinghua Changgung Hospital from January 2020 to November 2022 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them, 4 patients were male and 2 female, aged from 52 to 77 years, with a median age of 66 years.According to the Response Evaluation Criteria in Solid Tumors (RECIST version 1.1), clinical efficacy was evaluated as complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD), respectively.The objective response rate (ORR) and disease control rate (DCR) were calculated.The severity of adverse events was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.Survival analysis was performed by Kaplan-Meier method.

Results

During the neoadjuvant treatment,5 cases obtained PR and 1 case achieved SD.The ORR and DCR were 5/6 and 6/6, respectively.The overall incidence of adverse reactions was 4/6, and 1/6 for ＞grade 3 adverse reactions.During follow-up, 6 patients survived, including 5 cases of progress-free survival (PFS).Survival analysis showed that the median overall survival (OS) was 26.1 months and the median PFS was 19.0 months.The R0 resection rate reached 100% in 6 patients after neoadjuvant therapy.The postoperative 1-year OS rate was 100% and 83.3% for 1-year PFS.

Conclusions

Radiotherapy combined with targeted neoadjuvant immunotherapy is safe and efficacious for ICC.

Key words: Intrahepatic cholangiocarcinoma, Bile duct neoplasms, Neoadjuvant therapy, Radiotherapy, Targeted therapy, Immunotherapy