Smith Jessica L, Jacovides Christina L, Tucker Catherine M, Jiang Wei, Prestipino Anthony J, Yeo Charles J
Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Division of Trauma, Surgical Critical Care and Emergency Surgery, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA.
J Pancreat Cancer. 2021 Oct 7;7(1):71-73. doi: 10.1089/pancan.2021.0004. eCollection 2021.
Undifferentiated carcinoma with osteoclast-like giant cells/osteoclast-like giant cell reaction (UC-OGC) is a rare form of pancreatic cancer historically associated with a poor prognosis. Molecular tumor profiling provides new information about tumor origins and a more nuanced understanding of the potential efficacy of different chemotherapeutic agents. A 69-year-old man presented with a 13-cm periampullary pancreatic mass. Biopsy of a neighboring lymph node was consistent with adenocarcinoma. After neoadjuvant chemoradiation, the patient underwent resection and the tumor was consistent with UC-OGC. Next-generation sequencing was performed with genomic and proteomic analyses analyzed by a molecular tumor board review. These analyses revealed genetic alterations similar to those seen in pancreatic ductal adenocarcinoma, as well as potential therapeutic targets for the patient's subsequent therapy. Understanding a tumor's genetic changes allows for better understanding of its biology and may improve treatment efficacy. We believe that future study in tumor profiling will improve our understanding of rare cancers such as UC-OGC and also pave the way for the use of novel therapies to specifically target mutations in a broad range of more common tumors.
伴有破骨细胞样巨细胞/破骨细胞样巨细胞反应的未分化癌（UC-OGC）是一种罕见的胰腺癌形式，历来预后较差。分子肿瘤分析提供了有关肿瘤起源的新信息，并能更细致地了解不同化疗药物的潜在疗效。一名69岁男性患者出现一个13厘米的壶腹周围胰腺肿块。对邻近淋巴结的活检结果与腺癌相符。新辅助放化疗后，患者接受了手术切除，肿瘤符合UC-OGC。通过分子肿瘤专家委员会评审对基因组和蛋白质组分析进行了二代测序。这些分析揭示了与胰腺导管腺癌相似的基因改变，以及该患者后续治疗的潜在靶点。了解肿瘤的基因变化有助于更好地理解其生物学特性，并可能提高治疗效果。我们相信，未来对肿瘤分析的研究将增进我们对UC-OGC等罕见癌症的了解，也为使用新型疗法专门针对更广泛常见肿瘤中的突变铺平道路。
