[A Case of Transverse Colon Cancer Associated with Lynch Syndrome with Excellent Response to Pembrolizumab]

Gan To Kagaku Ryoho. 2023 Oct;50(10):1111-1113.
[Article in Japanese]

Abstract

A 47-year-old woman diagnosed with transverse colon cancer with liver, peritoneal, and lymph node metastases was admitted. Modified FOLFOX6(mFOLFOX6)regimen was given as a first line chemotherapy and was followed by pembrolizumab after 1 cycle of the mFOLFOX6, because microsatellite instability(MSI)test of the tumor showed high-frequency MSI. Because of the transverse colon obstruction after 2 cycles of pembrolizumab, she underwent right hemicolectomy. Histological examination of the resected specimen revealed no residual tumor cells in the primary tumor and reginal lymph nodes. Immunohistochemistry for mismatch repair proteins(IHC-MMR)showed loss of MSH2 and MSH6 expression. Genetic test identified a MSH2 pathogenic variant leading to the diagnosis of Lynch syndrome. The present case shows the importance of MSI test or IHC-MMR before the treatment of metastatic colorectal cancer.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Colon, Transverse* / pathology
  • Colon, Transverse* / surgery
  • Colonic Neoplasms* / complications
  • Colonic Neoplasms* / drug therapy
  • Colonic Neoplasms* / surgery
  • Colorectal Neoplasms, Hereditary Nonpolyposis* / drug therapy
  • Colorectal Neoplasms, Hereditary Nonpolyposis* / genetics
  • Colorectal Neoplasms, Hereditary Nonpolyposis* / surgery
  • DNA Mismatch Repair
  • Female
  • Humans
  • Microsatellite Instability
  • Middle Aged
  • MutL Protein Homolog 1 / genetics
  • MutL Protein Homolog 1 / metabolism
  • MutS Homolog 2 Protein / genetics

Substances

  • pembrolizumab
  • MutS Homolog 2 Protein
  • MutL Protein Homolog 1