文献类型：期刊文献

英文题名：Pathological complete response after neoadjuvant immunotherapy combined with chemotherapy in pediatric rectal carcinoma: A case report

作者：Cao, Xiaomeng[1,2];Luo, Jianwei[3];Zhao, Baoyin[1,2];Fu, Hongjiang[4];Kang, Wendi[5]

第一作者：Cao, Xiaomeng

通信作者：Kang, WD[1]

机构：[1]Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou, Gansu, Peoples R China;[2]940th Hosp Joint Logist Support Force Chinese Peop, Dept Gen Surg, Lanzhou, Gansu, Peoples R China;[3]Hunan Canc Hosp, Dept Radiol, Changsha, Hunan, Peoples R China;[4]Inner Mongolia Univ Nationalities, Hulunbuir Clin Med Coll, Hulunbuir, Inner Mongolia, Peoples R China;[5]Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Canc Ctr, Dept Intervent Therapy,Natl Clin Res Ctr Canc, Beijing, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Canc Ctr, Dept Intervent Therapy,Natl Clin Res Ctr Canc, Beijing, Peoples R China.

年份：2022

卷号：13

外文期刊名：FRONTIERS IN IMMUNOLOGY

收录：;Scopus(收录号：2-s2.0-85144127487);WOS:【SCI-EXPANDED(收录号:WOS:000899659900001)】；

语种：英文

外文关键词：pediatric colorectal cancer; pathological complete response; neoadjuvant immunotherapy; microsatellite instability-high; immune checkpoint inhibitors

摘要：BackgroundPediatric colorectal carcinoma (PCRC) is a rare non-embryonal tumor with an incidence of 0.1% to 1% of adults. Immune checkpoint inhibitors (ICIs) targeting programmed death-1 (PD-1) have shown significant efficacy in defective mismatch repair/Microsatellite instability-high (dMMR/MSI-H) metastatic CRC (mCRC). Although several studies have reported neoadjuvant immunotherapy (NIT) in MSI-H/dMMR non-mCRC patients, not all patients achieved pathological complete remission (pCR). There are differences between PCRC and adult colorectal carcinoma (CRC), and the role of NIT in PCRC remains to be further defined. Case presentationWe report the case of a 12-year-old child who was admitted to the hospital with abdominal pain and vomiting for more than 3 months. The child's diagnosis was difficult and complex. He was initially diagnosed with intestinal obstruction, eventually diagnosed with a rare PCRC and identified as locally advanced colorectal cancer (LACRC) with genetic sequencing results showing MSI-H. After a thorough evaluation by clinicians, he received 4 cycles of Camrelizumab (anti-PD-1 antibody) + CapeOx (capecitabine and oxaliplatin) NIT combination chemotherapy. Repeat imaging and all tumor markers were unremarkable, and R0 resection was achieved. Postoperative pathology showed a tumor regression grade (TRG) of 0 grade determined as pCR. Postoperative review has not shown any recurrence or metastasis to date and the prognosis is good. ConclusionPCRC should improve the diagnostic efficiency to prevent misdiagnosis and miss the best time for treatment. NIT and or chemotherapy can be a reasonable and effective treatment option for dMMR/MSI-H locally advanced PCRC. Our report provides some support and evidence for neoadjuvant immunotherapy for locally advanced PCRC, while highlighting the importance of preoperative detection of microsatellite status for locally advanced PCRC.