Division of Hematology and Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan.
ACT Genomics Co., Ltd., Taipei 114, Taiwan.
Curr Oncol. 2021 Nov 10;28(6):4587-4596. doi: 10.3390/curroncol28060388.
Poorly differentiated pancreatic neuroendocrine carcinomas (NECs) are rare and aggressive malignancies with rapid disease progression and early widespread metastasis. Given histology similarity, they are commonly treated with platinum-based chemotherapy as small cell lung cancer (SCLC). However, no standard treatment has been established for recurrent or progressive disease. We present an Asian patient with recurrent poorly differentiated pancreatic NEC after curative surgery and adjuvant chemotherapy with cisplatin and etoposide. The tumor mutational burden (TMB) was high. The patient received chemotherapy combined with maintenance immunotherapy with nivolumab and achieved promising and durable response, suggesting TMB could be a biomarker to identify NEC patients for immune checkpoint inhibitor (ICI) treatment.
分化差的胰腺神经内分泌癌（NEC）是罕见且侵袭性的恶性肿瘤，疾病进展迅速，早期广泛转移。鉴于组织学相似性，它们通常被作为小细胞肺癌（SCLC）采用铂类为基础的化疗进行治疗。然而，对于复发性或进展性疾病尚未确立标准治疗方案。我们报告了一例亚洲患者，在根治性手术后和以顺铂和依托泊苷为基础的辅助化疗后出现复发性分化差的胰腺 NEC，肿瘤突变负荷（TMB）较高。患者接受了化疗联合纳武利尤单抗维持免疫治疗，取得了有希望且持久的缓解，提示 TMB 可能是识别 NEC 患者进行免疫检查点抑制剂（ICI）治疗的生物标志物。
