PMC10149926_01
Schematic of treatment history and next-generation sequencing (NGS)-detected RET fusion. (A) The timeline of treatment and corresponding CA199 levels. (B) The schematic diagram and identification of the TRIM33-RET fusion. Sequencing reads of TRIM33 and RET are visualized by the Integrative Genomics Viewer (IGV).
fonc-13-1078076-g001.jpg
PMC10149926_01_fonc-13-1078076-g001.jpg
f1
His serum CA 19-9 level was above 10,000 U/ml ( Figure 1A ), and his carcinoembryonic antigen (CEA) level was 68.7 U/ml. Meanwhile, a somatic RET fusion (TRIM33-RET) was detected ( Figure 1B ). CA199 dropped from a very high level (>10,000 U/ml) to 29.5 U/ml ( Figure 1A ). Currently, it was concluded that the patient reached a partial response.
(A) CT images of primary pancreatic lesion with a size of 4.1 cm x 2 cm before treatment. (B) CT images of liver metastases with a size of 3.8 cm x 2.4 cm before treatment. Contrast-enhanced CT scan images completed in (C, D) November 2021, (E, F) March 2022, and (G, H) July 2022 demonstrating progressive decrease in the size of primary pancreatic and liver metastases.
fonc-13-1078076-g002.jpg
PMC10149926_01_fonc-13-1078076-g002.jpg
f2
A CT scan revealed a 4.1 x 2.0-cm mass in the pancreatic uncinate process and a 3.8 x 2.4-cm mass in the liver ( Figures 2A, B ). Four months later, the volume of the primary tumor decreased by approximately 39.0% ( Figures 2A, C ), and that of the metastases decreased by approximately 39.5% ( Figures 2B, D ) compared to that before treatment, and a partial response was confirmed. The patient's primary tumor and metastases were still shrinking ( Figures 2E-H ), and the progression-free survival was at least 12 months.