A case of dMMR/MSI-H/TMB-H colon cancer with brain metastasis treated with PD-1 monoclonal antibody
10.3724/zdxbyxb-2023-0547
- VernacularTitle:PD-1单抗治疗一例dMMR/MSI-H/TMB-H型结肠癌伴颅内转移瘤患者临床完全缓解
- Author:
Tao XIANG
1
;
Hangyu ZHANG
;
Weijia FANG
;
Wenbin CHEN
Author Information
1. 浙江大学医学院附属第一医院结直肠外科,浙江 杭州 310003
- Keywords:
Colorectal cancer;
Microsatellite instability-high;
High tumor mutation burden;
Brain metastasis;
Programmed death-1 monoclonal antibody;
Case report
- From:
Journal of Zhejiang University. Medical sciences
2024;53(1):58-63
- CountryChina
- Language:Chinese
-
Abstract:
A 70-year-old man had radical surgery for colon cancer one year before the symptoms of memory loss and decreasing cognitive function.Subsequent magnetic resonance imaging revealed a brain mass,which was surgically resected and confirmed to be metastatic intestinal adenocarcinoma.Immunohistochemistry of the primary tumor and brain metastasis showed mismatch repair deficiency.The patient received adjuvant chemotherapy after surgery.However,the brain metastasis relapsed one month after the last chemotherapy.Genetic testing on the resected colon tumor samples confirmed microsatellite instability-high with a high tumor mutation burden by 77.7 muts/Mb.The patient was subsequently treated with programmed death-1(PD-1)monoclonal antibody pembrolizumab(keytruda).The brain metastatic lesions were completely shrunk,and a complete clinical response was achieved.
