Abstract
Background: Genomic profiling of tissue biopsies can be used to investigate genomic alterations. Although genomic analysis is also useful for precision medicine of prostate cancer, it is unclear whether to apply the results of this analysis to treatment. Case presentation: A 62-year-old man underwent docetaxel therapy and enzalutamide for castration-resistant prostate cancer. However, he developed urinary retention and radiological images showed progression of prostate cancer. We performed prostate biopsy and trans-urethral resection of the prostate. Pathological examination showed acinar adenocarcinoma with intraductal carcinoma. Although docetaxel rechallenge and cabazitaxel therapy were attempted, the tumor expanded to the rectum and his systemic condition worsened gradually (Fig. 1). Palliative care was started and the patient was transferred to another hospital. We performed next-generation sequencing using DNA from FFPE tissue of the TUR-P specimen. We identified 4 genetic variants with in the FFPE tissue sample. Remarkably, CHEK2 alteration was known to be associated with some solid cancer progression. Conclusions: The results of genetic analysis suggested that modification of tumor suppressor pathways might be associated with refractory nature of his cancer.
A first Japanese Case of Intraductal Cancer of the Prostate with CHEK2 Mutation
