一例具有突变且肿瘤突变负荷高的三阴性前列腺癌患者先后接受奥拉帕利和帕博利珠单抗治疗。
A case of double-negative prostate cancer with mutation and high tumor mutation burden treated sequentially with olaparib and pembrolizumab.
作者信息
Tanaka Hiroki, Yoshida Soichiro, Aoyama Satoru, Ikeda Sadakatsu, Kunieda Junko, Ohashi Kenichi, Fukuda Shohei, Waseda Yuma, Tanaka Hajime, Fujii Yasuhisa
机构信息
Department of Urology Tokyo Medical and Dental University Tokyo Japan.
Department of Precision Cancer Medicine Tokyo Medical and Dental University Tokyo Japan.
出版信息
IJU Case Rep. 2024 Aug 4;7(5):395-398. doi: 10.1002/iju5.12766. eCollection 2024 Sep.
INTRODUCTION
Double-negative prostate cancer, an androgen receptor-independent prostate cancer without features of neuroendocrine tumors, is refractory to treatment but could be an ideal candidate for individualized treatment.
CASE PRESENTATION
An 85-year-old patient with metastatic castration-resistant prostate cancer without prostate-specific antigen progression presented with local recurrence and liver and lung metastases 6 months after orchiectomy and apalutamide. A liver tumor biopsy led to a diagnosis of double-negative prostate cancer. FoundationOne CDx showed mutation and high tumor mutation burden. Olaparib and pembrolizumab were administered sequentially, and the patient responded to each treatment for 5 months until radiographic progression.
CONCLUSION
Sequential use of olaparib and pembrolizumab may be effective for double-negative prostate cancer with mutations and high tumor mutation burden.
引言
双阴性前列腺癌是一种不依赖雄激素受体且无神经内分泌肿瘤特征的前列腺癌，对治疗具有耐药性，但可能是个体化治疗的理想候选对象。
病例介绍
一名85岁的转移性去势抵抗性前列腺癌患者，在睾丸切除术和阿帕鲁胺治疗6个月后出现局部复发以及肝和肺转移，且前列腺特异性抗原无进展。肝脏肿瘤活检确诊为双阴性前列腺癌。FoundationOne CDx检测显示存在 突变且肿瘤突变负荷高。先后给予奥拉帕利和帕博利珠单抗治疗，患者对每种治疗均有5个月的反应，直至影像学进展。
结论
对于存在 突变且肿瘤突变负荷高的双阴性前列腺癌，序贯使用奥拉帕利和帕博利珠单抗可能有效。
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