Successful replacement for recurrent nasopharyngeal carcinoma with cholecystitis induced by PD-1 antibody: a case report.

ABSTRACT

The occurrence of immune-related cholecystitis and the subsequent immunotherapy re-challenge has been rarely reported. A patient diagnosed with recurrent nasopharyngeal carcinoma, developed immune-related cholecystitis after the sixth and eighth cycles of camrelizumab respectively. The patient's symptoms and laboratory test results showed improvement after conservative treatment. Then we chose zimberelimab, a fully humanized PD-1 antibody, as a replacement for camrelizumab in maintenance therapy and successfully completed 37 cycles of zimberelimab (240 mg every 2 weeks per cycle). Surprisingly, the patient experienced no immune-related adverse event and remained in complete remission with a progression-free survival of 28.8 months. The use of Zimberelimab as rechallenge immunotherapy may be an optional choice after managing immune-related cholecystitis induced by other PD-1 antibodies.

Immunotherapy is a new and effective way to treat tumors, but it also brings many side effects. One of the side effects is gallbladder inflammation. Less than 1% of patients developed the gallbladder inflammation. It could lead to many kinds of uncomfortable symptoms and interrupt the tumor treatment. It is still unclear whether immunotherapy can be resumed after the gallbladder inflammation is resolved. We shared a patient who experienced gallbladder inflammation after immunotherapy, then we used another drug successfully to resume the immunotherapy. The patient did not develop any side effects, and the result of tumor treatment was very good. We are hoping this case can provide a reference for other similar patients.