Durable response from fibroblast growth factor receptor inhibition in intrahepatic cholangiocarcinoma terminated by metachronous acute myeloid leukemia: a case report

J Med Case Rep. 2023 Dec 15;17(1):550. doi: 10.1186/s13256-023-04231-2.

Abstract

Introduction: Advances in the treatment of biliary tract cancer have been made possible through gains in genomic and epigenetic tumor understanding. The use of fibroblast growth factor receptor inhibitor has enabled significant clinical improvement in a specific group of patients with intrahepatic cholangiocarcinoma, some of whom with very durable responses.

Case presentation: We present the case of a 69-year-old Caucasian patient with advanced intrahepatic cholangiocarcinoma who received the therapy with selective oral inhibitor of fibroblast growth factor receptor 1, 2, and 3 pemigatinib after multiple previous chemotherapies. This resulted in a durable stable disease condition for 15 months with good tolerability. The diagnosis of acute myeloid leukemia was an unanticipated serious adverse event, in which the impact of fibroblast growth factor receptor inhibition could not yet be determined due to inadequate data.

Conclusions: It is still possible to achieve durable tumor response in advanced previously treated intrahepatic cholangiocarcinoma through targeted therapies. The prolonged progression free survival means that there could be an increased risk of secondary malignancy in this patient group, which necessitates diagnostic and therapeutic strategies.

Keywords: Acute myeloid leukemia; Case report; Fibroblast growth factor receptor; Intrahepatic cholangiocarcinoma; Secondary malignancy; Targeted tumor therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bile Duct Neoplasms* / drug therapy
  • Bile Ducts, Intrahepatic / pathology
  • Cholangiocarcinoma* / drug therapy
  • Humans
  • Leukemia, Myeloid, Acute* / drug therapy
  • Receptors, Fibroblast Growth Factor / therapeutic use

Substances

  • Receptors, Fibroblast Growth Factor