CASE REPORT article
Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1560508
Combined Neoadjuvant Chemotherapy and Immunotherapy in a Hepatitis B Virus-Positive Patient with Locally Advanced Rectal Adenocarcinoma: A Case Report and Literature Review
Provisionally accepted
- 1Guangdong Nongken Central Hospital, Zhangjiang, China
- 2First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Microsatellite-stable (MSS) rectal adenocarcinoma remains a therapeutic challenge, particularly in patients with complicating factors such as chronic hepatitis B virus (HBV) infection. Advances in immunotherapy, including immune checkpoint inhibitors (ICIs), have introduced new opportunities for improving treatment outcomes in this subset, yet their application in HBV-positive cancer patients is less well understood. Here, we report the case of a 46-year-old female with MSS locally advanced rectal adenocarcinoma and active HBV infection, successfully treated with cmFOLFOXIRI combined with camrelizumab as neoadjuvant therapy. The patient presented with a circumferential rectal mass, elevated tumor markers, and virological evidence of high HBV viral load, necessitating prophylactic antiviral management with entecavir. Following five cycles of cmFOLFOXIRI and two cycles of camrelizumab, significant tumor regression was achieved, with further response observed after long-course radiotherapy combined with irinotecan and capecitabine.Laparoscopic low anterior resection revealed complete pathological remission (pCR), with no residual tumor cells or lymph node metastases identified. This case underscores the potential of integrating immunotherapy into multimodal neoadjuvant regimens for MSS rectal cancer while highlighting the critical importance of HBV management to minimize reactivation risks during treatment. These findings offer valuable insights into the safe and effective use of ICIs in HBV-positive cancer patients, warranting further investigation in larger clinical studies.
Keywords: Neoadjuvant Therapy, immune checkpoint inhibitors, colorectal cancer, Locally advanced rectal cancer, cmFOLFOXIRI
Received: 14 Jan 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Li, Wu, Xu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qiyun Li, Guangdong Nongken Central Hospital, Zhangjiang, China
Taidong Li, Guangdong Nongken Central Hospital, Zhangjiang, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.