Pulmonary metastasis secondary to abiraterone-resistant prostate cancer with homozygous deletions of BRCA2: First Japanese case

• Published in: IJU case reports 2021, Vol.4 (1), p.14-17
• Main Authors: Izawa, Mizuki, Kosaka, Takeo, Nakamura, Kohei, Oba, Junna, Hishida, Tomoyuki, Hongo, Hiroshi, Mikami, Shuji, Nishihara, Hiroshi, Oya, Mototsugu
• Format: Report
• Language: English
• ISSN: 2577-171X
• DOI: 10.1002/iju5.12224

INTRODUCTIONMost metastatic prostate cancers acquire the capacity for androgen-independent growth and become resistant to androgen deprivation therapy. A patient-focused treatment strategy is needed for aggressive castration-resistant prostate cancer.CASE PRESENTATIONWe report the case of a 62-year-old man who presented with prostatic adenocarcinoma who was treated by radiation and combined androgen blockade. After completion of first-line therapy, he was diagnosed with multiple metastatic castration-resistant prostate cancer in the lung. Second-line therapy with abiraterone acetate resulted in partial remission of the lung metastases. Thoracic surgery was performed to remove the single lung metastasis remaining. Next-generation sequencing of the specimens demonstrated homozygous loss of BRCA2. We note in this case a heterogeneous response to abiraterone acetate may be related to the somatic BRCA2 deletions.CONCLUSIONSWe present the first Japanese case of a metastatic abiraterone acetate-resistant castration-resistant prostate cancer accompanied by BRCA2 mutation.