Ravindranathan Deepak, Russler Greta Anne, Yantorni Lauren, Drusbosky Leylah M, Bilen Mehmet Asim
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Guardant Health, Inc, Redwood City, California, USA.
Case Rep Oncol. 2021 Mar 1;14(1):190-196. doi: 10.1159/000512819. eCollection 2021 Jan-Apr.
Pembrolizumab has been approved by the US Food and Drug Administration for the treatment of metastatic or unresectable solid tumors that are microsatellite instability-high (MSI-H) or mismatch repair deficient. Blood-based circulating tumor DNA (ctDNA) assays have been validated to identify tumors with MSI-H status without the need for tissue biopsy. We report 2 patients with metastatic castration-resistant prostate cancer (mCRPC) who had prior treatment with multiple lines of therapy and underwent ctDNA testing, which detected MSI-H status. Both patients were treated with pembrolizumab, resulting in an excellent clinical response measured with liquid biopsies before and after initiation of therapy, which demonstrated a significant reduction in somatic-variant allele frequency in addition to a decrease in prostate serum antigen levels.
帕博利珠单抗已被美国食品药品监督管理局批准用于治疗微卫星高度不稳定（MSI-H）或错配修复缺陷的转移性或不可切除实体瘤。基于血液的循环肿瘤DNA（ctDNA）检测已被验证可用于识别MSI-H状态的肿瘤，而无需进行组织活检。我们报告了2例转移性去势抵抗性前列腺癌（mCRPC）患者，他们之前接受了多线治疗并接受了ctDNA检测，检测到MSI-H状态。两名患者均接受了帕博利珠单抗治疗，治疗前后通过液体活检测量，临床反应良好，除了前列腺特异性抗原水平下降外，体细胞变异等位基因频率也显著降低。
