Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2025; 17(7): 106993
Published online Jul 27, 2025. doi: 10.4254/wjh.v17.i7.106993
Molecular tumor boards in pancreatic cancer with liver metastasis: A case report
Yan Yan, Zhi-Zhong Ren, Wen-Ya Wang, Jing Tang, Yue-Wei Zhang
Yan Yan, Jing Tang, Department of Clinical Pharmacy, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
Zhi-Zhong Ren, Yue-Wei Zhang, Department of Hepatobiliary Intervention, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
Wen-Ya Wang, Medical Research Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
Co-corresponding authors: Jing Tang and Yue-Wei Zhang.
Author contributions: Both Tang J and Zhang YW have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors; Zhang YW, Ren ZZ, and Wang WY designed the treatment plan; Ren ZZ and Yan Y collected and edited the figures; Yan Y wrote the manuscript; and Tang J revised the manuscript; All the authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors have no relevant conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Tang, Associate Chief Pharmacist, Department of Clinical Pharmacy, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. tj_0208@163.com
Received: March 20, 2025
Revised: April 27, 2025
Accepted: July 2, 2025
Published online: July 27, 2025
Processing time: 127 Days and 20.2 Hours
Abstract
BACKGROUND

Pancreatic cancer has limited treatment options and poor prognosis owing to late diagnosis and aggressive biology. Current therapies include surgery, chemotherapy, and radiation; however, the outcomes remain suboptimal. Molecular tumor boards (MTB) enhance personalized treatment by analyzing genomic data to identify targetable mutations and recommend precise therapies.

CASE SUMMARY

A 45-year-old male presented with jaundice in December 2022. Initial investigations revealed a pancreatic head mass and liver metastases; a liver biopsy confirmed moderately differentiated adenocarcinoma. The patient received multimodal therapies, including gemcitabine, albumin-bound paclitaxel, nimotuzumab, and proton radiotherapy, which initially resulted in significant shrinkage of the pancreatic lesion and a reduction in liver metastases. However, the disease eventually progressed, prompting further evaluation at our MTB clinic. Genetic testing revealed a homologous recombination deficiency (HRD) score of 58 (HRD-positive) and a pathogenic BRCA2 mutation (p.T3033fs), suggesting sensitivity to PARP inhibitors and platinum-based therapies. Based on these findings, the patient was administered olaparib, which, combined with immunotherapy (tislelizumab, atezolizumab) and hepatic arterial infusion chemotherapy (5-fluorouracil + leucovorin + oxaliplatin regimen), led to further stabilization and partial reduction of liver metastases. This case underscores the positive role of the MTB model in interpreting genetic profiles and guiding personalized treatment strategies for such patients.

CONCLUSION

The patient’s clinical course highlights the potential of MTB in providing significant benefits for advanced pancreatic cancer with liver metastases.

Keywords: Pancreatic adenocarcinoma; BRCA2 mutation; Homologous recombination deficiency; Hepatic arterial infusion chemotherapy; Molecular tumor boards; Case report

Core Tip: We report the case of a 45-year-old male with pancreatic head adenocarcinoma and liver metastases who underwent treatment with gemcitabine, albumin-bound paclitaxel, nimotuzumab, and proton radiotherapy. The tumor subsequently progressed, and the patient visited our molecular tumor boards (MTB) clinic. Repeat genetic testing revealed homologous recombination deficiency positivity (score 58) and a pathogenic BRCA2 mutation (p.T3033fs), prompting a shift to olaparib combined with immunotherapy (tislelizumab and atezolizumab) and hepatic arterial infusion chemotherapy (5-fluorouracil + leucovorin + oxaliplatin). This approach stabilized the disease and reduced liver metastases. MTB was crucial in interpreting genetic profiles and guiding personalized treatment, demonstrating the potential of MTB-driven strategies for treating advanced pancreatic cancer with liver metastases.