Yang WW, Yang L, Lu HZ, Sun YK. Long-term survival of a patient with pancreatic cancer and lung metastasis: A case report and review of literature. World J Clin Cases 2021; 9(30): 9134-9143 [PMID: 34786397 DOI: 10.12998/wjcc.v9.i30.9134]
Corresponding Author of This Article
Yong-Kun Sun, MD, Professor, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. hsunyk@cicams.ac.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2021; 9(30): 9134-9143 Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9134
Long-term survival of a patient with pancreatic cancer and lung metastasis: A case report and review of literature
Wen-Wei Yang, Lin Yang, Hai-Zhen Lu, Yong-Kun Sun
Wen-Wei Yang, Lin Yang, Yong-Kun Sun, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Hai-Zhen Lu, Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Yang WW contributed to the composition of the manuscript and literature review; Sun YK and Yang L contributed to patient treatment and evaluation; Lu HZ analyzed the pathological subtype of tumor tissues; Sun YK supported final approval of the paper; All authors contributed to manuscript revision, read and approved the final version.
Supported byWu Jieping Medical Foundation, No. 320.6750.2020-10-95; and Sanming Project of Medicine in Shenzhen, No. SZSM202011010.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Kun Sun, MD, Professor, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. hsunyk@cicams.ac.cn
Received: March 22, 2021 Peer-review started: March 22, 2021 First decision: July 5, 2021 Revised: July 13, 2021 Accepted: August 13, 2021 Article in press: August 13, 2021 Published online: October 26, 2021 Processing time: 213 Days and 2.5 Hours
Abstract
BACKGROUND
Pancreatic cancer (PC) is a leading cause of cancer-related death, given its poor prognosis and the limited benefits of traditional therapies. As tumors become more genetically disorganized as they progress, genetic mutations might become new markers for us to predict their behavior. Nowadays, many inhibitors can selectively target gene products as a form of targeted therapy, with some showing promise as treatment for various types of cancer.
CASE SUMMARY
We describe a rare case of a PC patient with long-term survival of more than 8 yr. The patient was diagnosed with pancreatic ductal adenocarcinoma (PDAC) with BAP1 and PIK3CA gene mutations and Raf1 fusion and achieved partial response twice after treatment with apatinib in combination with chemotherapy.
CONCLUSION
BAP1, PIK3CA mutations, and Raf1 fusion are rare in PDAC. Patients with these three gene alterations of PDAC may achieve long-term survival with apatinib. Further research in other contexts is needed to determine whether apatinib has ideal efficacy for PC treatment.
Core Tip: We report a patient with pancreatic ductal adenocarcinoma (PDAC) possessing exceptionally rare RAF1, BAP1 and PIK3CA gene alterations who achieved partial response to apatinib combination therapy twice and experienced long-term survival. Until now, there have been no reports of a long-term PDAC patient with RAF1, BAP1 and PIK3CA aberrations who did not also have K-Ras, TP53, p16/ CDKN2A, or SMAD4 gene alterations. In such a rare case, we presume that PDAC with this special genetic alteration pattern might be converted to a kind of indolent cancer, which presents fewer symptoms and indicates a good prognosis for pancreatic cancer patients.
