Wuwei Yang

A stage IV high-grade serous ovarian cancer patient carrying ERBB2 amplification and ERBB2 overexpression benefits from late-line pyrotinib treatment: A case report

Ovarian cancer (OC), one of the most common gynecological cancers, is usually diagnosed at an advanced stage. High-grade serous ovarian cancer (HGSOC) is a histological subtype of OC that accounts for approximately 70% of all OC cases. erb-b2 receptor tyrosine kinase 2 (ERBB2) overexpression commonly occurs in HGSOC, accounting for 12.5% of stage III and IV HGSOCs. Currently, there is no established treatment strategy for OC patients with ERBB2 amplification or ERBB2 overexpression. Whether these patients will benefit from ERBB2 inhibitors remains unclear. Herein, we report a patient with metastatic HGSOC carrying ERBB2 amplification and ERBB2 overexpression. Following progression to platinum-based chemotherapy and subsequent antiangiogenic therapies, the patient benefited from late-line pyrotinib treatment, achieving stable disease with a progression-free survival of 9.5 months. Our study provides preliminary clinical evidence supporting pyrotinib as a feasible treatment option for metastatic HGSOC patients with ERBB2 amplification and/or ERBB2 overexpression. Prospective trials of pyrotinib should be conducted in appropriately selected OC populations.

Exceptional Response of Cryoablation Followed by Pembrolizumab in a Patient with Metastatic Cervical Carcinosarcoma with High Tumor Mutational Burden: A Case Report

Abstract Cervical carcinosarcoma is an extremely rare type of neoplasm that lacks standard of care. Preclinical and clinical evidence has suggested that cryoablation in combination with immunotherapy may result in a synergistic effect, generating a more robust immune response to distant lesions. A few clinical trials have evaluated the efficacy of such combination treatment in a variety of solid tumors, but with conflicting results. This report describes the first clinical efficacy of cryoablation followed by pembrolizumab observed in a patient with tumor mutational burden (TMB)-high metastatic cervical carcinosarcoma that was negative for programmed cell death protein 1 expression, microsatellite instability stable, and had mutations in DNA polymerase epsilon (POLE). She had achieved complete response (CR) after 3 months of pembrolizumab treatment and had maintained CR as of the time of submission of this manuscript, with a progression-free survival of 11 months and counting. The case exhibited an exceptional response to cryoablation followed by pembrolizumab, potentially attributed to mutations in POLE, which lead to an extremely high TMB. This report paves the avenue for establishing treatment regimens for patients with TMB-high cervical carcinosarcoma. Key Points Owing to its rarity, cervical carcinosarcoma has not been well characterized, and currently, there is no standard of care for this disease. This report describes the first case of clinical efficacy of cryoablation followed by pembrolizumab observed in a patient with tumor mutational burden-high metastatic cervical carcinosarcoma. The case exhibited an exceptional response (maintained CR as of the time of submission of this article: 11 months) to cryoablation followed by pembrolizumab. This is the first POLE-mutated cervical carcinosarcoma case.