A remarkable and durable response to tislelizumab treatment of an anaplastic thyroid carcinoma without targetable genomic alterations: a case report
Anaplastic thyroid carcinoma (ATC) is a rare and highly aggressive malignancy characterized by a poor prognosis, with a median survival time of approximately 3 to 4 months. In this report, we present a case involving a 59-year-old patient diagnosed with ATC, who experienced swift local recurrence an...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1544604/full |
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| author | Jingjing Chai Jiaqi Lv Jian Xiong Xiuwen Chen Senyuan Luo Zhiguo Luo Zhiguo Luo Ming Luo |
| author_facet | Jingjing Chai Jiaqi Lv Jian Xiong Xiuwen Chen Senyuan Luo Zhiguo Luo Zhiguo Luo Ming Luo |
| author_sort | Jingjing Chai |
| collection | DOAJ |
| description | Anaplastic thyroid carcinoma (ATC) is a rare and highly aggressive malignancy characterized by a poor prognosis, with a median survival time of approximately 3 to 4 months. In this report, we present a case involving a 59-year-old patient diagnosed with ATC, who experienced swift local recurrence and pulmonary metastasis following radical thyroidectomy. Comprehensive Sanger sequencing of the resected tumor tissue revealed no mutations in the TERT promoter or the BRAF V600E gene. The patient exhibited rapid recurrence post-surgery and was deemed unsuitable for immediate surgical intervention. The patient was unable to tolerate chemotherapy; therefore, radiotherapy was administered initially to prevent airway compression resulting from disease progression. During the course of radiotherapy, pulmonary metastasis developed, yet the patient remained intolerant to both chemotherapy and anti-angiogenic therapy. Immunohistochemical analysis revealed a high expression of PD-L1. Whole exome sequencing (WES) indicated a tumor mutation burden (TMB) of 2.98 mut/Mb, microsatellite stability (MSS), and identified 10 missense mutations, 1 nonsense mutation, and 1 frameshift insertion. However, none of these mutations have corresponding targeted therapies. Consequently, we administered tislelizumab as an immunotherapeutic intervention. The patient exhibited significant regression in cervical metastatic lymph nodes and pulmonary metastatic tumors, achieving a sustained remission lasting 14 months, culminating in complete remission, without experiencing any adverse events related to immune checkpoint inhibitors. This case demonstrates the efficacy of second-line monotherapy with an immune checkpoint inhibitor (ICI) for ATC in a patient unable to tolerate chemotherapy and anti-angiogenic anlotinib treatment, thereby offering a viable treatment strategy for ATC patients. |
| format | Article |
| id | doaj-art-4aa57c766bfc4e5790f4f6270c070744 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-4aa57c766bfc4e5790f4f6270c0707442025-02-12T07:25:54ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-02-011610.3389/fimmu.2025.15446041544604A remarkable and durable response to tislelizumab treatment of an anaplastic thyroid carcinoma without targetable genomic alterations: a case reportJingjing Chai0Jiaqi Lv1Jian Xiong2Xiuwen Chen3Senyuan Luo4Zhiguo Luo5Zhiguo Luo6Ming Luo7Department of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, ChinaDepartment of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, ChinaCardiovascular Department, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, ChinaDepartment of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, ChinaDepartment of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, ChinaDepartment of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, ChinaKey Laboratory of Cancer Therapy Resistance and Clinical Translational Study, Shiyan, Hubei, ChinaDepartment of Oncology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, ChinaAnaplastic thyroid carcinoma (ATC) is a rare and highly aggressive malignancy characterized by a poor prognosis, with a median survival time of approximately 3 to 4 months. In this report, we present a case involving a 59-year-old patient diagnosed with ATC, who experienced swift local recurrence and pulmonary metastasis following radical thyroidectomy. Comprehensive Sanger sequencing of the resected tumor tissue revealed no mutations in the TERT promoter or the BRAF V600E gene. The patient exhibited rapid recurrence post-surgery and was deemed unsuitable for immediate surgical intervention. The patient was unable to tolerate chemotherapy; therefore, radiotherapy was administered initially to prevent airway compression resulting from disease progression. During the course of radiotherapy, pulmonary metastasis developed, yet the patient remained intolerant to both chemotherapy and anti-angiogenic therapy. Immunohistochemical analysis revealed a high expression of PD-L1. Whole exome sequencing (WES) indicated a tumor mutation burden (TMB) of 2.98 mut/Mb, microsatellite stability (MSS), and identified 10 missense mutations, 1 nonsense mutation, and 1 frameshift insertion. However, none of these mutations have corresponding targeted therapies. Consequently, we administered tislelizumab as an immunotherapeutic intervention. The patient exhibited significant regression in cervical metastatic lymph nodes and pulmonary metastatic tumors, achieving a sustained remission lasting 14 months, culminating in complete remission, without experiencing any adverse events related to immune checkpoint inhibitors. This case demonstrates the efficacy of second-line monotherapy with an immune checkpoint inhibitor (ICI) for ATC in a patient unable to tolerate chemotherapy and anti-angiogenic anlotinib treatment, thereby offering a viable treatment strategy for ATC patients.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1544604/fullanaplastic thyroid carcinomaPD-1 inhibitorPD-L1 expression levelwhole exome sequencingcase report |
| spellingShingle | Jingjing Chai Jiaqi Lv Jian Xiong Xiuwen Chen Senyuan Luo Zhiguo Luo Zhiguo Luo Ming Luo A remarkable and durable response to tislelizumab treatment of an anaplastic thyroid carcinoma without targetable genomic alterations: a case report Frontiers in Immunology anaplastic thyroid carcinoma PD-1 inhibitor PD-L1 expression level whole exome sequencing case report |
| title | A remarkable and durable response to tislelizumab treatment of an anaplastic thyroid carcinoma without targetable genomic alterations: a case report |
| title_full | A remarkable and durable response to tislelizumab treatment of an anaplastic thyroid carcinoma without targetable genomic alterations: a case report |
| title_fullStr | A remarkable and durable response to tislelizumab treatment of an anaplastic thyroid carcinoma without targetable genomic alterations: a case report |
| title_full_unstemmed | A remarkable and durable response to tislelizumab treatment of an anaplastic thyroid carcinoma without targetable genomic alterations: a case report |
| title_short | A remarkable and durable response to tislelizumab treatment of an anaplastic thyroid carcinoma without targetable genomic alterations: a case report |
| title_sort | remarkable and durable response to tislelizumab treatment of an anaplastic thyroid carcinoma without targetable genomic alterations a case report |
| topic | anaplastic thyroid carcinoma PD-1 inhibitor PD-L1 expression level whole exome sequencing case report |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1544604/full |
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