Paredes de la Fuente Rodrigo, Doolin James W, Peters Mary Linton
Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
BMJ Case Rep. 2023 Feb 6;16(2):e251936. doi: 10.1136/bcr-2022-251936.
A previously healthy man in his 60s was diagnosed with a rare histological subtype of pancreatic cancer, adenosquamous carcinoma. After somatic mutation profiling, it was found that the tumour had microsatellite instability status high and a high tumour mutational burden. The patient was started on combination therapy with gemcitabine, nab-paclitaxel and pembrolizumab. Tumour size and biomarkers showed a dramatic response eventually leading to the patient being transitioned to maintenance therapy with pembrolizumab. The patient has demonstrated continued response since the start of the treatment. This is the first report in the literature showing a sustained response in this type of neoplasm that was treated with a checkpoint inhibitor, and thus adds to the evidence supporting universal somatic testing in all pancreatic cancers for a tailored approach to therapy.
一名60多岁的既往健康男性被诊断患有胰腺癌的一种罕见组织学亚型——腺鳞癌。在进行体细胞突变分析后，发现该肿瘤具有微卫星高度不稳定状态和高肿瘤突变负荷。患者开始接受吉西他滨、纳米白蛋白结合型紫杉醇和帕博利珠单抗的联合治疗。肿瘤大小和生物标志物显示出显著反应，最终患者转为接受帕博利珠单抗维持治疗。自治疗开始以来，患者一直有持续反应。这是文献中首次报道在这类接受检查点抑制剂治疗的肿瘤中出现持续反应，因此为支持对所有胰腺癌进行普遍体细胞检测以制定个体化治疗方案的证据增添了内容。
