Contributors: Isidori, F.; Malvi, D.; Fittipaldi, S.; Forcato, C.; Bozzarelli, I.; Sala, C.; Raulli, G.; D'Errico, A.; Fiorentino, M.; Seri, M.; Krishnadath, K. K.; Bonora, E.; Mattioli, S.; Lugaresi, M. L.; Castellani, G.; Fiocca, R.; Mastracci, L.; Rasanen, J.; Soderstrom, H.
نبذة مختصرة : Background: We report on a female patient who underwent primary radical resection for a stage 2B Her-2-positive Barrett's-type esophageal adenocarcinoma (EAC). Despite Her-2 targeted therapy, her disease recurred and required repeated metastectomies. Case presentation: Digital cell sorting and targeted sequencing of cancer sub-clones from EAC and metastases revealed a completely mutated TP53, whereas the sorted stromal cells were wild-type. Her-2 amplification was significantly lower in the metastases when the patient became therapy-resistant. Conclusions: The mechanism of therapy resistance illustrated by this case could only be detected through accurate analysis of tumor sub-populations. Investigating tumor sub-populations of recurrent disease is important for adjusting therapy in recurrent EAC.
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