{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:06:19Z","timestamp":1776722779059,"version":"3.51.2"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009448","name":"Universit\u00e0 degli Studi della Campania Luigi Vanvitelli","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009448","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Canc Conf J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This case report describes the clinical management of a 68-year-old man with concurrent invasive melanoma and metastatic castration-resistant prostate cancer (mCRPC). Initially diagnosed with BRAF V600E-mutated melanoma, he received Dabrafenib and Trametinib. Later, prostate cancer was diagnosed with bilateral pulmonary metastases. Despite initial treatment with Triptorelin, Docetaxel, and Abiraterone, disease progression occurred. A liquid biopsy revealed an extremely high Tumor Mutational Burden (TMB) and mutations including\n                    <jats:italic>POLE, BRCA2, ATM, and TP53.<\/jats:italic>\n                    Due to the high TMB, off-label Pembrolizumab was initiated. Radiological evaluations at 3 and 6\u00a0months showed a marked response, with disappearance of target lung metastases and durable remission maintained through February 2025. Only grade 1 asthenia was reported, without significant treatment interruptions. This case illustrates the value of precision medicine and the role of liquid biopsy in guiding immunotherapy decisions for complex oncological cases. It supports the relevance of molecular profiling in selecting effective treatments beyond standard indications.\n                  <\/jats:p>","DOI":"10.1007\/s13691-025-00833-3","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T19:10:21Z","timestamp":1768245021000},"page":"189-194","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pembrolizumab for high TMB castration-resistant prostate cancer: A precision medicine case report"],"prefix":"10.1007","volume":"15","author":[{"given":"Vincenzo","family":"Terrano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Perri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Cioffo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giusi","family":"Mastroianni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Antonina","family":"Palumbo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fortunato","family":"Ciardiello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Troiani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3504-8349","authenticated-orcid":false,"given":"Stefania","family":"Napolitano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"833_CR1","doi-asserted-by":"publisher","first-page":"175883592091530","DOI":"10.1177\/1758835920915302","volume":"12","author":"EF Giunta","year":"2020","unstructured":"Giunta EF et al (2020) Optimal treatment strategy for metastatic melanoma patients harboring BRAF V600 mutations. 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Clin Cancer Res 21(7):1639\u20131651. https:\/\/doi.org\/10.1158\/1078-0432.CCR-14-2339","journal-title":"Clin Cancer Res"},{"key":"833_CR4","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.phrs.2018.08.019","volume":"136","author":"M Kuske","year":"2018","unstructured":"Kuske M et al (2018) Immunomodulatory effects of BRAF and MEK inhibitors: implications for Melanoma therapy. Pharmacol Res 136:151\u2013159. https:\/\/doi.org\/10.1016\/j.phrs.2018.08.019","journal-title":"Pharmacol Res"},{"key":"833_CR5","doi-asserted-by":"publisher","DOI":"10.1200\/PO.21.00267","volume":"6","author":"B Garmezy","year":"2022","unstructured":"Garmezy B et al (2022) Clinical and molecular characterization of POLE mutations as predictive biomarkers of response to immune checkpoint inhibitors in advanced cancers. 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IJU Case Rep 8(5):449\u2013453. https:\/\/doi.org\/10.1002\/iju5.70062","journal-title":"IJU Case Rep"}],"container-title":["International Cancer Conference Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13691-025-00833-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13691-025-00833-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13691-025-00833-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:15:44Z","timestamp":1774952144000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13691-025-00833-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":19,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["833"],"URL":"https:\/\/doi.org\/10.1007\/s13691-025-00833-3","relation":{},"ISSN":["2192-3183"],"issn-type":[{"value":"2192-3183","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"assertion":[{"value":"3 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"All procedures performed in this study were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Institutional ethics approval was waived as this is a retrospective single-patient case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}