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Published on: August 12, 2015
A case of double-negative prostate cancer with BRCA2 mutation and high tumor mutation burden treated sequentially
Hiroki Tanaka1, Soichiro Yoshida1, Satoru Aoyama2
1Department of Urology Tokyo Medical and Dental University Tokyo Japan.
Introduction:
Double-negative prostate cancer, an androgen receptor-independent prostate cancer without features of neuroendocrine tumors, is refractory to treatment but could be an ideal candidate for individualized treatment.
Case Presentation:
An 85-year-old patient with metastatic castration-resistant prostate cancer without prostate-specific antigen progression presented with local recurrence and liver and lung metastases 6 months after orchiectomy and apalutamide. A liver tumor biopsy led to a diagnosis of double-negative prostate cancer. FoundationOne® CDx showed BRCA2 mutation and high tumor mutation burden. Olaparib and pembrolizumab were administered sequentially, and the patient responded to each treatment for 5 months until radiographic progression.
Conclusion:
Sequential use of olaparib and pembrolizumab may be effective for double-negative prostate cancer with BRCA2 mutations and high tumor mutation burden.
Insights
Double-negative prostate cancer, a rare form of prostate cancer, is challenging to treat. Sequential treatment with olaparib and pembrolizumab showed promise in a patient with BRCA2 mutations and high tumor mutation burden.
Area of Science:
- Oncology
- Genetics
Background:
- Double-negative prostate cancer (DNPC) is an androgen receptor-independent subtype.
- DNPC is refractory to conventional treatments and lacks neuroendocrine features.
Observation:
- An 85-year-old male with metastatic castration-resistant prostate cancer developed DNPC.
- The patient had liver and lung metastases and a BRCA2 mutation with high tumor mutation burden.
Findings:
- Sequential administration of olaparib and pembrolizumab resulted in a 5-month response to each agent.
- The patient experienced radiographic progression after sequential treatment.
Implications:
- Sequential olaparib and pembrolizumab may offer a treatment option for DNPC.
- Targeted therapy and immunotherapy combinations warrant further investigation for DNPC.
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