医学
神经内分泌癌
肿瘤科
癌
内科学
神经内分泌肿瘤
小学(天文学)
癌症研究
物理
天文
作者
Blake McKinley,Tucker W Coston,Jason S. Starr
标识
DOI:10.1093/oncolo/oyae034
摘要
Abstract We present a 54-year-old White male with a diagnosis of stage IV pancreatic neuroendocrine carcinoma. Next-generation sequencing of the tumor/blood identified a complex tumor genome, which included a rearranged during transfection (RET) gene fusion. The patient initially received cytotoxic chemotherapy with a significant radiographic response. After 4 cycles of chemotherapy, the patient was transitioned to a clinical trial using selpercatinib, a RET inhibitor, as maintenance therapy. Unfortunately, our patient developed progression of disease at the first treatment monitoring scan. Our patient suffered primary resistance to RET-targeted therapy. Proposed mechanisms of resistance include intrinsic resistance of the nuclear receptor co-activator 4-RET fusion to RET inhibition, the RET fusion representing a passenger alteration to another tumorigenic driver pathway and/or decreased efficacy of RET inhibition after platinum-based chemotherapy. Our patient’s clinical course highlights the fact that “actionable” genomic alterations do not always equate to patient benefit.
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