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Updated: Jul 1, 2025

Quantifying Antibody-Dependent Cellular Cytotoxicity in a Tumor Spheroid Model: Application for Drug Discovery
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Durable Response to Programmed Death 1-Directed Antibodies in a Hypermutated Triple-Negative Breast Cancer: A Case

Emilie Platteter1, Gerburg Wulf2

  • 1Phase One Cancer Clinical Trials, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Case Reports in Oncology
|March 4, 2024
PubMed
Abstract

Insights

Pembrolizumab, a programmed cell death 1 inhibitor, effectively treated recurrent triple-negative breast cancer (TNBC) in a hypermutated patient. This immune-oncologic (IO) agent provided a durable response without significant toxicity.

Area of Science:

  • Oncology
  • Immunotherapy

Background:

  • Immune checkpoint inhibitors represent a significant advancement in cancer therapy.
  • Pembrolizumab (Keytruda) has shown success in combination therapy for triple-negative breast cancer (TNBC).
  • Limited data exists on pembrolizumab monotherapy for TNBC, especially with rare tumor mutational burden.

Observation:

  • A 65-year-old patient with recurrent TNBC and pulmonary metastases was treated.
  • Next-generation sequencing revealed a hypermutated tumor with rare polyploidy.
  • The patient received pembrolizumab as a programmed cell death 1 inhibitor.

Findings:

  • The patient experienced a durable 14-month response and ongoing remission.
  • No serious immune checkpoint inhibitor-related toxicities were observed.
  • The treatment demonstrated efficacy in a rare case of hypermutated recurrent TNBC.

Implications:

  • This case highlights the potential of pembrolizumab monotherapy in select TNBC patients.
  • Hypermutation may be a predictive biomarker for response to immune-oncologic agents.
  • Further research is warranted on pembrolizumab for rare TNBC subtypes.
Keywords:
Case reportHypermutated tumorImmune-oncologyMicrosatellite instability-highNext-generation sequencingProgrammed death 1Triple-negative breast cancer

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