Progression-free survival 3 of 22 months achieved through third-line therapy with adebrelimab in patient with recurrent chordoma: a case report.

Lower cervical spine origin chordomas are exceedingly uncommon tumors, and treatment may present difficulties in particular areas of the cervical spine owing to its specific anatomic architecture and the interrelationship with the vertebral arteries, cervical nerve roots, and spinal cord. Due to its rarity, the mechanisms underlying tumorigenesis and optimal therapeutic strategies for recurrence remain poorly understood. A 57-year-old Chinese female with large vertebral and paravertebral lesions from C6 to T1 underwent surgically resection on Aug 13, 2018. The pathological diagnosis in the post-operative report was chordoma close to the resection margin. No adjuvant treatment was administered after surgery. The first recurrence occurred three years postoperatively and was associated with a high tumor burden. At that time, paraplegia (lower limb paralysis and involuntary urinary and fecal control disorders) occurred. This patient received apatinib tablets, a vascular endothelial growth factor receptor (VEGFR)-tyrosine kinase inhibitor (TKI), as first-line treatment. Second-line administration of a VEGFR-TKI anlotinib capsules and programmed death-1 (PD-1) inhibitor toripalimab injection; third-line administration of the programmed death-ligand 1 (PD-L1) inhibitor adebrelimab injection, resulted in a progression-free survival 3 of 22 months and an overall survival of 7.5 years. To the best of our knowledge, this represents the first reported case of adebrelimab use in immunotherapy for chordoma.