Case Report: Successful conversion of gallbladder cancer with intrahepatic metastases using camrelizumab combined with gemcitabine and cisplatin.

Résumé

BACKGROUND: Gallbladder cancer is an extremely aggressive malignant tumor of the digestive system. It presents with no obvious symptoms in its early stages, meaning most patients are already in advanced stages at diagnosis. The response to neoadjuvant therapy for gallbladder cancer is poor, and the majority of patients with advanced gallbladder cancer cannot achieve tumor downstaging through drug treatment to become eligible for surgery. This case focuses on discussing the selection of immunotherapy drugs and the determination of their treatment cycles.CASE SUMMARY: This case report describes a patient with gallbladder cancer and intrahepatic metastases. Following contrast-enhanced computed tomography (CECT) evaluation, R0 resection of the lesions was deemed unfeasible. The patient underwent conversion therapy with camrelizumab combined with gemcitabine and cisplatin. The patient responded well to this regimen, with rapid tumor shrinkage after three cycles of treatment. Grade IV neutropenia developed during therapy but resolved without serious consequences following prompt intervention. After reassessment, the patient underwent open cholecystectomy combined with segmental resection of the liver segments IVb/V, lymph node dissection, and high hepaticojejunal anastomosis. Postoperative recovery was favorable, with PFS reaching 18 months.CONCLUSION: The regimen of camrelizumab combined with gemcitabine and cisplatin demonstrated potential conversion therapy value in this patient with advanced gallbladder cancer. However, its definitive efficacy and the specific role of camrelizumab still require validation through large-scale clinical trials.