Department of Medicine, Division of Hematology & Oncology, University of California, San Francisco, CA, 94158, USA.
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, 94158, USA.
Immunotherapy. 2021 Oct;13(15):1249-1254. doi: 10.2217/imt-2021-0008. Epub 2021 Aug 2.
Mismatch repair protein deficiency occurs in 0.8-2% of pancreatic ductal adenocarcinomas and confers susceptibility to immunotherapy. Herein, we report the case of a patient with Lynch syndrome-associated, locally advanced mismatch repair protein deficiency pancreatic ductal adenocarcinomas who demonstrated a sustained response to second-line treatment with pembrolizumab, but eventually developed immune-related diabetic ketoacidosis requiring discontinuation of treatment. He has since remained in remission, off treatment, over the following 3 years, with regular surveillance showing no clinical or radiographic evidence of disease progression. The patient's unusual disease course raises the question of whether this serious immune-related adverse event affecting the organ of malignant involvement may have predicted his remarkable and durable response.
错配修复蛋白缺陷发生于 0.8-2%的胰腺导管腺癌中，并使其易感性增加，进而对免疫治疗产生应答。在此，我们报告了 1 例林奇综合征相关、局部晚期错配修复蛋白缺陷胰腺导管腺癌患者，该患者二线治疗帕博利珠单抗后获得持续缓解，但最终出现免疫相关糖尿病酮症酸中毒，需要停止治疗。此后，他在接下来的 3 年中持续缓解，未进行治疗，定期监测显示疾病无临床或影像学进展。患者这种不寻常的疾病过程提出了一个问题，即这种影响恶性肿瘤器官的严重免疫相关不良事件是否可能预示着他的显著和持久反应。
