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She initially demonstrated a clinical benefit with reduced tumor markers and favorable imaging findings. However, disease progression occurred after eight months. Liquid biopsy\u2010based genomic profiling identified three PALB2 reversion mutations that restored homologous recombination, leading to treatment resistance. The case illustrates both the therapeutic potential of PARP inhibitors in PALB2\u2010mutated cancers and the emergence of resistance. It emphasizes the importance of liquid biopsy\u2010based genomic profiling for understanding tumor evolution and guiding treatment strategies.<\/jats:p>","DOI":"10.1111\/cas.70210","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T10:22:22Z","timestamp":1759746142000},"page":"3540-3544","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergence of\n                    <scp>\n                      <i>PALB2<\/i>\n                    <\/scp>\n                    Reversion Mutations as a Mechanism of Resistance to Niraparib in Breast Cancer: A Case Report"],"prefix":"10.1111","volume":"116","author":[{"given":"Maako","family":"Kawamura","sequence":"first","affiliation":[{"name":"Personalized Medicine Center Tohoku University Hospital  Sendai 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