Treatment of advanced intrahepatic cholangiocarcinoma with sintilimab combined with tegafur-gimeracil-oteracil potassium capsules (S-1): a case report

Ann Palliat Med. 2020 Mar;9(2):497-503. doi: 10.21037/apm.2020.03.14. Epub 2020 Mar 19.


Advanced intrahepatic cholangiocarcinoma (ICC) is a highly challenging malignancy characterized by rapid progression and poor prognosis. Although programmed cell death-1/programmed cell death1 ligand-1 (PD-1/PD-L1) inhibitors licensed abroad have achieved certain effectiveness in treating various tumors, few studies have investigated the efficacies of these drugs on advanced ICC. Here, we describe a 63-year-old female patient with stage IV ICC involving the porta hepatis, retroperitoneal lymph nodes, and left adrenal gland, along with right femur metastasis. She suffered from lower back pain that had affected her sleep. A pathological fracture of her right femur was detected. Multiple lymph node metastases were found in the left adrenal glands, porta hepatis, and retroperitoneum. She failed the first- and secondline chemotherapies. After 6 cycles of combined therapy with sintilimab injection (PD-1) and tegafurgimeracil-oteracil potassium capsules (S-1), the patient's condition gradually improved and finally achieved partial remission (PR). The patient's pain score decreased, and her quality of life was significantly improved. The third-line treatment was efficacious and significantly improved survival. We can therefore speculate that PD-1 plays an important role in the treatment of advanced ICC and can benefit patients with similar conditions.

Keywords: Intrahepatic cholangiocarcinoma (ICC); chemotherapy; sintilimab; tegafur-gimeracil-oteracil potassium capsules.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bile Duct Neoplasms / drug therapy*
  • Bile Duct Neoplasms / pathology
  • Cholangiocarcinoma / diet therapy*
  • Cholangiocarcinoma / pathology
  • Drug Combinations
  • Female
  • Humans
  • Middle Aged
  • Oxonic Acid / therapeutic use
  • Pyridines / therapeutic use
  • Tegafur / therapeutic use


  • Antibodies, Monoclonal, Humanized
  • Drug Combinations
  • Pyridines
  • tegafur-gimeracil-oteracil
  • Tegafur
  • Oxonic Acid
  • sintilimab