A refractory case of CDK4-amplified spinal astrocytoma achieving complete response upon treatment with a Palbociclib-based regimen:a case report

• Main Authors: Jietao Lin, Ling Yu, Yuanfeng Fu, Hanrui Chen, Xinting Zheng, Shutang Wang, Chan Gao, Yang Cao, Lizhu Lin
• Format: Article
• Language: English
• Published: BMC 2020-07-01
• Series: BMC Cancer
• Subjects: Spinal astrocytoma; next-generation sequencing; Palbociclib; Targeted therapy
• Online Access: http://link.springer.com/article/10.1186/s12885-020-07061-3

Abstract Background Spinal cord astrocytoma is a rare neoplasm, and patients usually recur within months after surgery. There is currently a lack of consensus regarding post-operative treatment. Clinical data on the activity of systemic treatment like chemoradiotherapy and anti-angiogenic agents also remained scant. Next-generation sequencing (NGS) -based genomic profiling thus may help identify potential treatment options for a subset of patients that harbor actionable genetic alterations. Case presentation We reported for the first time a refractory case of grade III spinal cord astrocytoma that underwent two surgeries but eventually progressed following post-operative chemoradiotherapy plus bevacizumab. Hybridization capture-based NGS using a 381-gene panel disclosed cyclin dependent kinase 4 (CDK4) amplification and after receiving a triplet regimen containg palbociclib for 15 months, the patient achieved complete response. Conclusions This case demonstrated the importance of genetic profiling and the benefit of a multi-modality treatment strategy in cancer management.