医学
癌症研究
免疫疗法
表型
无容量
达卡巴嗪
替莫唑胺
肿瘤科
甲状腺癌
心脏毒性
甲状腺髓样癌
内科学
癌症
化疗
黑色素瘤
生物
遗传学
基因
作者
Sophie Moog,Livia Lamartina,Mohamed Amine Bani,Abir Al Ghuzlan,Luc Friboulet,Antoîne Italiano,Ludovic Lacroix,Sophie Postel‐Vinay,Lambros Tselikas,Frédèric Deschamps,Baptiste Bonnet,Fabiana Pani,Éric Baudin,Julien Hadoux
出处
期刊:Thyroid
[Mary Ann Liebert]
日期:2023-11-01
卷期号:33 (11): 1368-1373
被引量:1
标识
DOI:10.1089/thy.2023.0144
摘要
Background: Patients with metastatic medullary thyroid cancer (MTC) who progressed under tyrosine kinase inhibitors can benefit from an alkylating agent such as dacarbazine or temozolomide. Patient Findings: We describe two patients with metastatic MTC who developed a hypermutant phenotype after alkylating agent treatment. This phenotype was characterized by a high tumor mutational burden (TMB) and a mutational signature indicative of alkylating agent mutagenesis (single-base substitution 11). Both patients received immune checkpoint inhibitors, with partial morphological responses, clinical benefit, and progression-free survival of 6 and 9 months, respectively. Summary and Conclusions: Based on the described observations, we suggest that a hypermutant phenotype may be induced after alkylating agent treatment for MTC and the sequential use of immunotherapy should be further explored as a treatment option for MTC patients with increased TMB.
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