Pembrolizumab efficacy in a tumor mutation burden-high glioblastoma patient: A case study and implications for precision oncology.

IF 5.7 2区医学 Q1 Medicine

Cancer Science Pub Date : 2024-10-25 DOI:10.1111/cas.16370

Akihiro Nishiyama, Shigeki Sato, Hiroyuki Sakaguchi, Hiroshi Kotani, Kaname Yamashita, Koushiro Ohtsubo, Tomoko Sekiya, Atsushi Watanabe, Atsushi Tajima, Chie Shimaguchi, Keishi Mizuguchi, Hiroko Ikeda, Masashi Kinoshita, Mitsutoshi Nakada, Shinji Takeuchi

引用次数: 0

Abstract

A glioblastoma (GBM) patient with a high tumor mutation burden (TMB-high) and mismatch repair deficiency (dMMR) exhibited a significant response to pembrolizumab, an immune checkpoint inhibitor (ICI), despite prior treatment with temozolomide (TMZ), known to induce hypermutation and potential resistance to ICIs. The rapid disease progression, indicated by 80% Ki67 positivity, was markedly countered by the positive outcome of pembrolizumab treatment. This case challenges traditional GBM treatment paradigms, demonstrating the potential of precision oncology in patients with significant TMB and dMMR, and underscores the importance of comprehensive genomic profiling in guiding clinical decisions in GBM management.

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Pembrolizumab对肿瘤突变负荷高的胶质母细胞瘤患者的疗效：病例研究及对精准肿瘤学的影响。

一位患有高肿瘤突变负荷（TMB-high）和错配修复缺陷（dMMR）的胶质母细胞瘤（GBM）患者对免疫检查点抑制剂（ICI）pembrolizumab的治疗产生了显著反应，尽管患者之前曾接受过替莫唑胺（TMZ）治疗，而已知替莫唑胺会诱发高突变并可能对ICI产生耐药性。Ki67阳性率高达80%，表明疾病进展迅速，而pembrolizumab治疗的积极效果则明显逆转了这一趋势。该病例挑战了传统的 GBM 治疗范式，展示了精准肿瘤学在具有显著 TMB 和 dMMR 的患者中的潜力，并强调了全面基因组分析在指导 GBM 临床治疗决策中的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Science ONCOLOGY-

CiteScore

9.90

自引率

3.50%

发文量

406

审稿时长

17 weeks

期刊介绍： Cancer Science (formerly Japanese Journal of Cancer Research) is a monthly publication of the Japanese Cancer Association. First published in 1907, the Journal continues to publish original articles, editorials, and letters to the editor, describing original research in the fields of basic, translational and clinical cancer research. The Journal also accepts reports and case reports. Cancer Science aims to present highly significant and timely findings that have a significant clinical impact on oncologists or that may alter the disease concept of a tumor. The Journal will not publish case reports that describe a rare tumor or condition without new findings to be added to previous reports; combination of different tumors without new suggestive findings for oncological research; remarkable effect of already known treatments without suggestive data to explain the exceptional result. Review articles may also be published.