Complete pathological response to pembrolizumab in pretreated pancreatic acinar cell carcinoma

Background Therapeutic approach used for pancreatic ductal adenocarcinoma is usually translated also for the rarer acinar counterpart, which shows a different mutational landscape nevertheless. While dMMR/MSI-H status is rare in the ductal histotype, it appears to be more prevalent in pancreatic aci...

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Published in:Journal of cancer research and clinical oncology 2024-07, Vol.150 (7), p.347, Article 347
Main Authors: Merz, Valeria, Maines, Francesca, Marcucci, Stefano, Sartori, Chiara, Frisinghelli, Michela, Trentin, Chiara, Kadrija, Dzenete, Carbone, Francesco Giuseppe, Michielan, Andrea, Gabbrielli, Armando, Melisi, Davide, Barbareschi, Mattia, Brolese, Alberto, Caffo, Orazio
Format: Article
Language:English
Subjects:
Adenocarcinoma
Aged
Antibodies, Monoclonal, Humanized - therapeutic use
Antigens
Antineoplastic Agents, Immunological - therapeutic use
Cancer Research
Cancer therapies
Carcinoma, Acinar Cell - drug therapy
Carcinoma, Acinar Cell - pathology
Case Report
Hematology
Hospitals
Humans
Internal Medicine
Male
Medical imaging
Medical prognosis
Medical research
Medicine
Medicine & Public Health
Middle Aged
Mutation
Oncology
Pancreas
Pancreatic cancer
Pancreatic carcinoma
Pancreatic Neoplasms - drug therapy
Pancreatic Neoplasms - pathology
Patients
PD-1 protein
Pembrolizumab
Tomography
Tumors
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Summary:Background Therapeutic approach used for pancreatic ductal adenocarcinoma is usually translated also for the rarer acinar counterpart, which shows a different mutational landscape nevertheless. While dMMR/MSI-H status is rare in the ductal histotype, it appears to be more prevalent in pancreatic acinar cell carcinoma (PACC). Case presentation We report the case of a patient with locally advanced MSI-H PACC in whom the treatment with the anti-PD-1 pembrolizumab, administered as third line, made possible surgical resection, achieving even an exceptional pathological complete response. Conclusions Treatment of PACC should be tailored based on the peculiar molecular features that distinguish PACC from ductal adenocarcinoma. Evaluation of potentially therapeutically targetable alterations should be mandatory in case of PACC diagnosis.
ISSN:1432-1335
0171-5216
1432-1335
DOI:10.1007/s00432-024-05841-z