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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Taylor & Francis Group
2025-12-01
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| 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. |
| format | Article |
| id | doaj-art-ccdf09abebd148c9afb4ad7e17383c9d |
| institution | OA Journals |
| issn | 2164-5515 2164-554X |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| 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 |