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Gan To Kagaku Ryoho. 2013 Nov;40(12):1759-61.

[The case of a patient with peritoneal metastasis from cholangiocarcinoma who responded to adoptive immunotherapy and cetuximab].

[Article in Japanese]

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Kan Norimichi Clinic.


A 59-year-old female patient underwent pancreaticoduodenectomy because of bile duct cancer 4 years before the first consultation at our clinic. Because the resected bile duct margin was positive, radiation therapy was administered to the hepatic hilum, 5-fluorouraci(l 5-FU) was continuously infused, and S-1 was administered as adjuvant therapy. Three years later, cancer of the uterine body was diagnosed. At the time of hysterectomy, nodules were observed in the Douglas pouch. Biopsy confirmed the presence of peritoneal metastasis from cholangiocarcinoma (hospital A). At the time of the first consultation, ascites was observed. Symptoms improved after the administration of bevacizumab( Bmab) and gemcitabine (GEM), but recurred after 7 months. The patient was admitted to hospital B because of impaired gastrointestinal passage and massive ascites. OK-432-combined adoptive immunotherapy, in which lymphocytes from the removed ascites were cultured and transferred into the abdominal cavity after OK-432 treatment, was performed. Examination of the specimen resected in hospital A indicated that it was strongly positive for epidermal growth factor receptor (EGFR), and hence, cetuximab( Cmab) was administered both at admission and after discharge. Cmab alone was continued and the tumor marker levels normalized. The patient is currently healthy at 7 years after the onset of peritoneal recurrence (5.5 years after the initiation of Cmab therapy).

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