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    Association details:
    Biomarker:ARID1A mutation + MSI-H
    Cancer:Lung Adenocarcinoma
    Drug:Opdivo (nivolumab) (PD1 inhibitor)
    Direction:Resistant
    Evidence:
    Evidence Level:
    Resistant: C4 – Case Studies
    Source:
    J Med Case Rep
    Title:

    ARID1A genomic alterations driving microsatellite instability through somatic MLH1 methylation with response to immunotherapy in metastatic lung adenocarcinoma: a case report

    Published date:
    02/19/2021
    Excerpt:
    Liquid biopsy test reported actionable alterations in ARID1A gene...Nivolumab 3 mg/kg intravenously every 2 weeks was administered for 38 cycles....The patient was treated with immunotherapy, and showed a treatment response lasting for 19 months until a new metastasis appeared at the right deltoid muscle. Genomic analysis of a sample of this metastasis confirmed PD-L1 positivity of greater than 50% with CD8+ T cells expression and showed MSI with a deleterious c.298C>T (p.R100*) MLH1 gene mutation.
    DOI:
    10.1186/s13256-020-02589-1
    Test:
    PD-L1 IHC 22C3 pharmDx, Guardant360® CDx, OncoDEEP