PDF(Pubmed)
Abstract：
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).
METHODS: 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.
METHODS: 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.
摘要：
背景：用于胰腺导管腺癌的治疗方法通常也适用于较罕见的腺泡对应物，尽管如此，这显示了不同的突变景观。虽然dMMR/MSI-H状态在导管组织型中很少见，它似乎在胰腺腺泡细胞癌（PACC）中更为普遍。
方法：我们报告了一例局部晚期MSI-HPACC患者，其中使用抗PD-1派姆单抗治疗，作为三线管理，使手术切除成为可能，甚至达到异常的病理完全反应。
结论：PACC的治疗应根据区分PACC和导管腺癌的特殊分子特征进行调整。在PACC诊断的情况下，评估潜在的治疗可靶向改变应该是强制性的。
方法：我们报告了一例局部晚期MSI-HPACC患者，其中使用抗PD-1派姆单抗治疗，作为三线管理，使手术切除成为可能，甚至达到异常的病理完全反应。
结论：PACC的治疗应根据区分PACC和导管腺癌的特殊分子特征进行调整。在PACC诊断的情况下，评估潜在的治疗可靶向改变应该是强制性的。
