Complete pathological response to pembrolizumab in pretreated pancreatic acinar cell carcinoma

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2024年7月11日

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Valeria Merz,
Francesca Maines,
Stefano Marcucci,
Chiara Sartori,
Michela Frisinghelli,
Chiara Trentin,
Dzenete Kadrija,
Francesco Giuseppe Carbone,
Andrea Michielan,
Armando Gabbrielli,
Davide Melisi,
Mattia Barbareschi,
Alberto Brolese,
Orazio Caffo

摘要

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.