Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2018; 10(4): 103-107
Published online Apr 15, 2018. doi: 10.4251/wjgo.v10.i4.103
EGFR amplification induces sensitivity to antiEGFR therapy in pancreatic acinar cell carcinoma
Corentin Richard, Julie Niogret, Romain Boidot, Francois Ghiringhelli
Corentin Richard, Romain Boidot, Francois Ghiringhelli, Platform of Transfer in Oncology, Center GF Leclerc, Dijon 21000, France
Corentin Richard, Romain Boidot, Francois Ghiringhelli, INSERM U1231, Dijon 21000, France
Corentin Richard, Francois Ghiringhelli, University of Bourgogne Franche Comte, Dijon 21000, France
Julie Niogret, Francois Ghiringhelli, Department of Medical Oncology, Georges Francois Leclerc Cancer Center, Dijon 21000, France
Author contributions: Boidot R and Ghiringhelli F designed the report; Richard C and Niogret J performed the genetic analyses; Ghiringhelli F collected the patient’s clinical data; Boidot R and Ghiringhelli F analyzed the data and wrote the paper.
Informed consent statement: The patient gave their written consent to authorize genetic analyses.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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:
Correspondence to: Francois Ghiringhelli, MD, Professor, Department of Medical Oncology, Georges Francois Leclerc Cancer Center, 1 Rue Pr Marion, Dijon 21000, France.
Telephone: +33-380-393353 Fax: +33-380-393434
Received: December 22, 2017
Peer-review started: December 22, 2017
First decision: January 6, 2018
Revised: February 1, 2018
Accepted: March 6, 2018
Article in press: March 6, 2018
Published online: April 15, 2018

Pancreatic acinar cell carcinoma (PACC) is a rare cancer. When the tumor is metastatic, few therapeutic options are available. Precision medicine using next-generation sequencing is defined by the administration of drugs based on the tumor genetic mutations. The usage of precision medicine for finding new therapeutic options for rare cancers is an emerging field. We have reported here the case of a patient bearing a multitreated metastatic PACC. This patient underwent somatic and constitutional exome analyses. The analyses revealed in the liver metastasis an amplification of the EGFR gene. Accordingly, the patient was treated with off-label usage of panitumumab. We observed rapid response with necrosis of the liver metastasis, while no efficacy was observed in the primary tumor. An exome analysis of the primary tumor revealed amplification of HER2 and MET with EGFR amplification. Such amplifications are known as a resistance mechanism to antiEGFR therapy. Our results suggest that exome analysis may be helpful to highlight targets in rare cancers, such as PACC. EGFR amplification in this pathology should be determined and could be used as a biomarker to propose antiEGFR therapy.

Keywords: Pancreatic cancer, Acinar cell carcinoma, Exome, Genetic mutations, Precision medicine

Core tip: The role of genetic profiling for therapy of rare cancer for precision medicine is currently under investigation. This case report reports, for the first time, that pancreatic acinar cell carcinoma could benefit from precision medicine and that EGFR gene amplification could be targetable by antiEGFR monoclonal antibody in this pathology.