CASE REPORT article
Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1670818
This article is part of the Research TopicInnovative Therapeutic Approaches for Complex Cancers: Exploring New StrategiesView all 15 articles
Dual Checkpoint Inhibition with Bevacizumab Yields Dramatic Response in Synchronous Double Primary HCC and ICC with Lung Metastasis
Provisionally accepted
Yu-cheng He
Xin-ye DaiYing-hao LvXiao-juan Yang
Qing-yun Xie
Si-nan XieYun-shi CaiFeng-wei Gao*
Tian Lan*- West China Hospital of Sichuan University, Chengdu, China
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Background: Due to its rarity, synchronous double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma (sdpHCC-ICC) presents significant challenges for preoperative diagnosis and is lacking established systemic therapies. Here, we present an extremely rare case of unresectable collision-type sdpHCC-ICC with pulmonary metastases, who achieved significant responses in both pulmonary metastases and hepatic lesions following combination immunotherapy. Case Report: This case report describes a 69-year-old male diagnosed with collision-type sdpHCC-ICC accompanied by pulmonary metastases. The patient underwent combination immunotherapy with dual immune therapy of nivolumab plus ipilimumab and bevacizumab, achieving complete remission (CR) of pulmonary lesions and partial response (PR) in hepatic lesions. Subsequent surgical resection of the residual liver tumor and postoperative adjuvant therapy resulted in favorable long-term outcomes. Conclusion: Our study reports the first case that systematic therapy achieved successful conversion therapy in an unresectable sdpHCC-ICC. Combination immunotherapy might represent a promising therapeutic strategy for sdpHCC-ICC, warranting further validation.
Keywords: Synchronous double primary hepatocellular carcinoma and intrahepaticcholangiocarcinoma (sdpHCC-ICC), Combination immunotherapy, PD-1, CTLA-4, bevacizumab, Conversion therapy
Received: 22 Jul 2025; Accepted: 16 Oct 2025.
Copyright: © 2025 He, Dai, Lv, Yang, Xie, Xie, Cai, Gao and Lan. 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:
Feng-wei Gao, gaofengwei@scu.edu.cn
Tian Lan, blue_sky_land@163.com
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.