ArticleClinical journal of gastroenterology2023
Discordant microsatellite instability findings in two samples from a patient with biliary cancer that responded to pembrolizumab.
Article in Clinical journal of gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Response to pembrolizumab after progression on durvalumab in cholangiocarcinoma: a case report of immune checkpoint inhibitor switching.Clinical journal of gastroenterology · 2026Article
- Microsatellite-high intrahepatic cholangiocarcinoma with favorable treatment outcome using pembrolizumab.Clinical journal of gastroenterology · 2025Article
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Authors and funding
10 authors.
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Abstract
Microsatellite instability (MSI) is a key marker to predict response to immune checkpoint inhibitors; however, only 1-2% of biliary cancers have this genomic feature. In a patient with hilar biliary cancer, MSI was examined in two cancer specimens (forceps biopsy from the biliary stricture and endoscopic ultrasound-guided fine-needle aspiration biopsy [EUS-FNAB] from the adjacent lymph node). We observed discordant results, as high frequency of MSI was found only in the forceps biopsy. Although the FNAB sample was 10 times larger than that of the forceps biopsy, the tumor concentration was much lower, which is a possible reason for the discordance. Besides, immunohistochemistry of four mismatch-repair (MMR) proteins showed proficient MMR expressions. The tumor became refractory to gemcitabine, cisplatin, and S-1 but responded well to pembrolizumab. Caution is needed for sample selection and for interpretation of the test's results, to avoid missing rare chance for effective molecular target agents.
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