TMB-High, MSI-High Castration-Resistant Prostate Cancer Treated With Pembrolizumab

Q4 Medicine

IJU Case Reports Pub Date : 2025-06-20 DOI:10.1002/iju5.70062

Satoshi Muraoka, Hisanobu Tosuji, Yuya Iwahashi, Hiroki Kawabata, Ryusuke Deguchi, Takahito Wakamiya, Shimpei Yamashita, Yasuo Kohjimoto, Isao Hara

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Abstract

Introduction

The use of pembrolizumab in patients with microsatellite instability-high (MSI-high) and tumor mutation burden-high (TMB-high) prostate cancer in Japan is not widely reported. Here, we report the case of a patient with MSI-high and TMB-high prostate cancer who responded well to pembrolizumab after multiple systemic treatments.

Case Presentation

A 68-year-old Japanese man was diagnosed with cT4N1M1a prostate cancer. He was treated with several androgen receptor signaling inhibitors and chemotherapy. After intense systemic treatment, disease progression was confirmed, and genomic testing detected MSI-high and TMB-high. However, treatment with pembrolizumab resulted in marked prostate-specific antigen reduction and significant shrinkage of metastases.

Conclusion

Genomic tests should be considered for high-grade tumors. MSI-high and TMB-high prostate cancer responded well to pembrolizumab in this case, but patients should be carefully monitored for the development of side effects after administration of pembrolizumab.

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Pembrolizumab治疗tmb -高、msi -高去势抵抗性前列腺癌

pembrolizumab在日本微卫星不稳定性高（MSI-high）和肿瘤突变负担高（TMB-high）前列腺癌患者中的应用尚未得到广泛报道。在这里，我们报告了一例msi -高和tmb -高前列腺癌患者，经过多次全身治疗后，对派姆单抗反应良好。一名68岁的日本男性被诊断为cT4N1M1a前列腺癌。他接受了几种雄激素受体信号抑制剂和化疗。经过强烈的全身治疗，确认疾病进展，基因组检测检测到msi -高和tmb -高。然而，使用派姆单抗治疗可显著减少前列腺特异性抗原和显著缩小转移灶。结论高级别肿瘤应考虑基因组检测。在这种情况下，msi -高和tmb -高前列腺癌对派姆单抗反应良好，但患者在使用派姆单抗后应仔细监测其副作用的发展。

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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