{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T01:55:11Z","timestamp":1774576511648,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>BRCA2 alterations and high tumor mutational burden (TMB\u2010H) are responsible for prostate cancer; however, their co\u2010occurrence is uncommon, and evidence for PARP inhibition in the castration\u2010sensitive setting remains limited. We describe a case of metastatic castration\u2010resistant prostate cancer (CRPC) harboring both biomarkers, showing a marked response to olaparib.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 74\u2010year\u2010old man presented with urinary retention. Initial prostate\u2010specific antigen (PSA) level was 11\u2009ng\/mL. Follow\u2010up MRI revealed bilateral PI\u2010RADS 5 lesions with seminal\u2010vesicle invasion. Biopsy confirmed adenocarcinoma (Gleason score 5\u2009+\u20095\u2009=\u200910). Staging revealed osseous and 30\u2010mm right internal iliac nodal metastasis. Genomic profiling identified a pathogenic BRCA2 mutation and near\u2010threshold TMB. Chemohormonal therapy was discontinued early owing to severe infection, and olaparib was initiated. Over 3\u2009months, MRI showed further regression of the primary lesion and nodal disease, and PSA and SCC decreased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In metastatic CRPC harboring a BRCA2 mutation and near\u2010threshold TMB, olaparib produced clear radiological and serological responses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iju5.70144","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T13:16:27Z","timestamp":1769606187000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Drastic Response to Olaparib in a Patient With Metastatic Castration\u2010Resistant Prostate Cancer Harboring\n                    <scp>BRCA2<\/scp>\n                    Alterations and Near\u2010Threshold Tumor Mutational Burden"],"prefix":"10.1002","volume":"9","author":[{"given":"Kotaro","family":"Yokota","sequence":"first","affiliation":[{"name":"Department of Urology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4371-4594","authenticated-orcid":false,"given":"Takeo","family":"Kosaka","sequence":"additional","affiliation":[{"name":"Department of Urology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuaki","family":"Daimon","sequence":"additional","affiliation":[{"name":"Department of Urology Eiju General Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9241-2373","authenticated-orcid":false,"given":"Shinnosuke","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Urology Nerima General Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Keio Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Nishihara","sequence":"additional","affiliation":[{"name":"Keio Cancer Center Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mototsugu","family":"Oya","sequence":"additional","affiliation":[{"name":"Department of Urology Keio University School of Medicine  Tokyo 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Urology"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1911440"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2024.01.011"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30445-9"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-21-0327"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-23-3403"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/PO.21.00531"},{"issue":"43","key":"e_1_2_8_11_1","first-page":"4709","article-title":"BRCA1 and BRCA2: Different Roles in a Common Pathway of Genome Protection","volume":"31","author":"Roy 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