Immunotherapy-induced microsatellite instability status shift in recurrent perihilar cholangiocarcinoma: A case report

Immunotherapy revolutionized the treatment of biliary tract tumors and tumors with high microsatellite instability (MSI-H). This paper reports a 52-year-old woman with recurrent perihilar cholangiocarcinoma. The tumor was initially microsatellite stable (MSS) and proficient mismatch repair (pMMR) bu...

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Main Authors: Hailing Yu, Tan Deng, Hongbing Liu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Human Vaccines & Immunotherapeutics
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Online Access:https://www.tandfonline.com/doi/10.1080/21645515.2025.2471226
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author Hailing Yu
Tan Deng
Hongbing Liu
author_facet Hailing Yu
Tan Deng
Hongbing Liu
author_sort Hailing Yu
collection DOAJ
description Immunotherapy revolutionized the treatment of biliary tract tumors and tumors with high microsatellite instability (MSI-H). This paper reports a 52-year-old woman with recurrent perihilar cholangiocarcinoma. The tumor was initially microsatellite stable (MSS) and proficient mismatch repair (pMMR) but shifted to MSI-H and deficient mismatch repair (dMMR) after combined immunotherapy. Following laparoscopic radical resection for jaundice, stage IV recurrence was diagnosed. Genetic testing revealed the MSS status. Subsequent treatment with camrelizumab and lenvatinib led to a partial response. Ovarian metastases, removed due to abdominal symptoms, exhibited dMMR and MSI-H. The mismatch in MSI status between the primary tumor and metastases suggests tumor heterogeneity and the influence of spatial or temporal factors. This shift can have important clinical significance since MSI-H is associated with significant responses to immune checkpoint inhibitors. MSI-H should be systematically tested in tumors and metastases to personalize treatments. MSI heterogeneity is not only rare but potentially has implications for treatment personalization and prognosis in patients with cholangiocarcinoma. This case highlights the dynamic changes in tumor characteristics during immunotherapy.
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spelling doaj-art-ccdf09abebd148c9afb4ad7e17383c9d2025-08-20T02:38:14ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2471226Immunotherapy-induced microsatellite instability status shift in recurrent perihilar cholangiocarcinoma: A case reportHailing Yu0Tan Deng1Hongbing Liu2Department of Oncology, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, ChinaDepartment of Oncology, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, ChinaDepartment of Oncology, Xiangtan First People’s Hospital, Changsha, Hunan, ChinaImmunotherapy revolutionized the treatment of biliary tract tumors and tumors with high microsatellite instability (MSI-H). This paper reports a 52-year-old woman with recurrent perihilar cholangiocarcinoma. The tumor was initially microsatellite stable (MSS) and proficient mismatch repair (pMMR) but shifted to MSI-H and deficient mismatch repair (dMMR) after combined immunotherapy. Following laparoscopic radical resection for jaundice, stage IV recurrence was diagnosed. Genetic testing revealed the MSS status. Subsequent treatment with camrelizumab and lenvatinib led to a partial response. Ovarian metastases, removed due to abdominal symptoms, exhibited dMMR and MSI-H. The mismatch in MSI status between the primary tumor and metastases suggests tumor heterogeneity and the influence of spatial or temporal factors. This shift can have important clinical significance since MSI-H is associated with significant responses to immune checkpoint inhibitors. MSI-H should be systematically tested in tumors and metastases to personalize treatments. MSI heterogeneity is not only rare but potentially has implications for treatment personalization and prognosis in patients with cholangiocarcinoma. This case highlights the dynamic changes in tumor characteristics during immunotherapy.https://www.tandfonline.com/doi/10.1080/21645515.2025.2471226Recurrent perihilar cholangiocarcinomacombined immunotherapymicrosatellite instability statustumor heterogeneitycase report
spellingShingle Hailing Yu
Tan Deng
Hongbing Liu
Immunotherapy-induced microsatellite instability status shift in recurrent perihilar cholangiocarcinoma: A case report
Human Vaccines & Immunotherapeutics
Recurrent perihilar cholangiocarcinoma
combined immunotherapy
microsatellite instability status
tumor heterogeneity
case report
title Immunotherapy-induced microsatellite instability status shift in recurrent perihilar cholangiocarcinoma: A case report
title_full Immunotherapy-induced microsatellite instability status shift in recurrent perihilar cholangiocarcinoma: A case report
title_fullStr Immunotherapy-induced microsatellite instability status shift in recurrent perihilar cholangiocarcinoma: A case report
title_full_unstemmed Immunotherapy-induced microsatellite instability status shift in recurrent perihilar cholangiocarcinoma: A case report
title_short Immunotherapy-induced microsatellite instability status shift in recurrent perihilar cholangiocarcinoma: A case report
title_sort immunotherapy induced microsatellite instability status shift in recurrent perihilar cholangiocarcinoma a case report
topic Recurrent perihilar cholangiocarcinoma
combined immunotherapy
microsatellite instability status
tumor heterogeneity
case report
url https://www.tandfonline.com/doi/10.1080/21645515.2025.2471226
work_keys_str_mv AT hailingyu immunotherapyinducedmicrosatelliteinstabilitystatusshiftinrecurrentperihilarcholangiocarcinomaacasereport
AT tandeng immunotherapyinducedmicrosatelliteinstabilitystatusshiftinrecurrentperihilarcholangiocarcinomaacasereport
AT hongbingliu immunotherapyinducedmicrosatelliteinstabilitystatusshiftinrecurrentperihilarcholangiocarcinomaacasereport