Cohen Romain, Sroussi Marine, Pilati Camilla, Houry Sidney, Laurent-Puig Pierre, André Thierry
Sorbonne Université, Department of Oncology, AP-HP, Hôpital Saint-Antoine, Paris, France.
Laboratoire de médecine personnalisée, pharmacogénomique et optimisation thérapeutique (UMR-S1147) Université Paris Descartes, Sorbonne Paris Cité, INSERM, Paris, France.
J Gastrointest Oncol. 2018 Aug;9(4):E23-E27. doi: 10.21037/jgo.2018.05.10.
Here we report the case of a 20-year-old patient who was diagnosed in 2002 with a metastatic colorectal cancer (CRC). He achieved a complete response under cetuximab-based therapy and remains without disease recurrence until now while chemotherapy was discontinued in 2009. The tumor exhibited high level of epidermal growth factor receptor () amplification, no mutation in , or genes and a microsatellite-stable (MSS) phenotype. Intriguingly this young patient was carrying a monoallelic germline mutation of that was associated with an inactivation of the second allele by loss of heterozygosity on tumor DNA. Moreover, this mutation was associated with a specific mutational signature on tumor level characterized by C > A single base substitutions and a higher mutational load than usually observed in MSS neoplasms. This case report paves the way for further researches on -associated cancers' sensitivity to anticancer therapies.
在此,我们报告一例20岁患者,其于2002年被诊断为转移性结直肠癌(CRC)。他在基于西妥昔单抗的治疗下实现了完全缓解,并且至今仍无疾病复发,而化疗于2009年停止。肿瘤表现出高水平的表皮生长因子受体()扩增,、或基因无突变,且为微卫星稳定(MSS)表型。有趣的是,这位年轻患者携带单等位基因种系突变,该突变与肿瘤DNA上杂合性缺失导致的第二个等位基因失活有关。此外,这种突变与肿瘤水平上的特定突变特征相关,其特征为C>A单碱基替换,且突变负荷高于MSS肿瘤通常观察到的水平。本病例报告为进一步研究相关癌症对抗癌治疗的敏感性铺平了道路。