Case Report: Effectiveness of Targeted Treatment in a Patient With Pancreatic Cancer Harboring PALB2 Germline Mutation and KRAS Somatic Mutation

Frontiers in Medicine

Mian Xu¹  Aibin Zhang¹  Lulu Liu¹  Dazhi Li¹  Yu Liu¹  Weijia Fang²  Yuzhi Jin²  Wei Wu²  Yixuan Guo²  Qing Hao²  Peng Zhao³ 

[1] Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Hangzhou, Zhejiang, China;;Department of Medical Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University &OrigiMed, Shanghai, China;

关键词: pancreatic cancer;    PALB2 germline mutation;    KRAS somatic mutation;    targeted therapy;    case report;   

DOI  :  10.3389/fmed.2021.746637

来源: DOAJ

【 摘 要 】

Pancreatic cancer is one of the most leading causes of cancer death worldwide. The rapid development of next-generation sequencing (NGS) and precision medicine promote us to seek potential targets for the treatment of pancreatic cancer. Here, we report a female pancreatic cancer patient who underwent radical surgical excision after neoadjuvant chemotherapy. After the surgery, the patient underwent gemcitabine + S-1 therapy, capecitabine + albumin paclitaxel therapy and irinotecan therapy successively, however, MRI review revealed tumor progression. The surgical tissue sample was subjected to next-generation sequencing (NGS), and PALB2 germline mutation and KRAS somatic mutation were identified. The patient then received olaparib (a PARP inhibitor) + irinotecan and the disease stabilized for one year. Due to the increased CA19-9, treatment of the patient with a combination of trametinib (a MEK inhibitor) and hydroxychloroquine resulted in stable disease (SD) with a significant decrease of CA19-9. This case demonstrated that the NGS may be a reliable method for finding potential therapeutic targets for pancreatic cancer.

【 授权许可】

Unknown