A Case of Advanced Extramammary Paget's Disease With a High Tumor Mutation Burden That Showed Partial Lymph Node Regression With Pembrolizumab.

Autor:	Horisaki K; Dermatology, Nagoya University, Nagoya, JPN., Taki T; Dermatology, Nagoya University, Nagoya, JPN., Mori S; Dermatology, Nagoya University, Nagoya, JPN., Okumura M; Dermatology, Nagoya University, Nagoya, JPN., Akiyama M; Dermatology, Nagoya University, Nagoya, JPN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 28; Vol. 16 (10), pp. e72592. Date of Electronic Publication: 2024 Oct 28 (Print Publication: 2024).
DOI:	10.7759/cureus.72592
Abstrakt:	Pembrolizumab has been found effective against various solid tumors with high tumor mutation burden, but there are no reports of successful treatment with pembrolizumab for extramammary Paget's disease (EMPD) with a high tumor mutation burden (TMB). This report describes a 71-year-old male patient who presented with irregularly shaped erythematous lesions on his scrotum, which had been there for several years. He was diagnosed with EMPD. A gene panel test indicated a high TMB. Six months after radical surgery, many lymph node metastases were found. We started a combination chemotherapy of tegafur-gimeracil-oteracil potassium (TS-1) and docetaxel. After three courses, a CT scan showed reductions in the sizes of all the metastatic lesions. However, the treatment was switched to pembrolizumab at the patient's request. After four cycles of the pembrolizumab treatment, a CT scan showed further shrinkage in most of the lymph node metastases. As far as we know, the present patient is the first case of advanced EMPD with response to pembrolizumab monotherapy. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Horisaki et al.)
Databáze:	MEDLINE
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