• Internal medicine · Nov 2023

    Successful Treatment of Metastatic Gallbladder Carcinoma with a High Tumor Mutational Burden Using Pembrolizumab: A Case Report.

    • Sanae Uehara, Atsushi Naganuma, Nozomi Furuichi, Ai Furusawa, Takuya Kaburagi, Hiroaki Naruse, Shota Tomaru, Nozomi Sano, Yuhei Suzuki, Tomoyuki Masuda, Takashi Hoshino, Hidetoshi Yasuoka, Yuko Tanaka, Shuichi Saito, Takeshi Hatanaka, and Satoru Kakizaki.
    • Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Japan.
    • Intern. Med. 2023 Nov 1; 62 (21): 315131563151-3156.

    AbstractA woman in her 70s presented with gallbladder carcinoma with liver metastases and peritoneal dissemination. After standard chemotherapy failed, a liver biopsy was performed. A FoundationOne CDx analysis showed that the tumor mutational burden (TMB) was high (34 mutations/megabase). Treatment with pembrolizumab, which is an immune checkpoint inhibitor (ICI), resulted in a partial response, and there were no significant immune-related adverse events. According to recently published reports, the frequency of TMB-high biliary tract cancer (BTC) is 3.4-4%, which makes it extremely rare. In conclusion, ICIs may be effective in patients with TMB-high BTC.

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