Targeted therapy of advanced parathyroid carcinoma guided by genomic and transcriptomic profiling

Research output: Contribution to journalResearch articleContributed


  • Maria-Veronica Teleanu - , German Cancer Research Center (DKFZ) (Author)
  • Carmina T Fuss - , Basurto University Hospital (Author)
  • Nagarajan Paramasivam - , Computational Oncology Group (Author)
  • Sebastian Pirmann - , Computational Oncology Group (Author)
  • Andreas Mock - , German Cancer Research Center (DKFZ) (Author)
  • Christoph Terkamp - , Leibniz University Hannover (LUH) (Author)
  • Stefan Kircher - , University Hospital of Würzburg (Author)
  • Laura-Sophie Landwehr - , Basurto University Hospital (Author)
  • Christina Lenschow - , Basurto University Hospital (Author)
  • Nicolas Schlegel - , Basurto University Hospital (Author)
  • Albrecht Stenzinger - , University Hospital Heidelberg (Author)
  • Arne Jahn - , Institute of Clinical Genetics, ERN GENTURIS, Hereditary Cancer Syndrome Center (Author)
  • Martin Fassnacht - , Basurto University Hospital (Author)
  • Hanno Glimm - , German Cancer Consortium (Partner: DKTK, DKFZ), DRESDEN-concept, Department of internal Medicine I, National Center for Tumor Diseases (Partners: UKD, MFD, HZDR, DKFZ), University Medical Center Mainz , National Center for Tumor Diseases (NCT) Dresden, German Cancer Research Center (DKFZ), University Hospital Carl Gustav Carus Dresden, Helmholtz-Zentrum Dresden-Rossendorf (Author)
  • Daniel Hübschmann - , Computational Oncology Group (Author)
  • Stefan Fröhling - , German Cancer Research Center (DKFZ) (Author)
  • Matthias Kroiss - , Basurto University Hospital (Author)


Parathyroid carcinoma (PC) is an ultra-rare malignancy with a high risk of recurrence after surgery. Tumour-directed systemic treatments for PC are not established. We used whole-genome and RNA sequencing in four patients with advanced PC to identify molecular alterations that could guide clinical management. In two cases, the genomic and transcriptomic profiles provided targets for experimental therapies that resulted in biochemical response and prolonged disease stabilization: (a) immune checkpoint inhibition with pembrolizumab based on high tumour mutational burden and a single-base substitution signature associated with APOBEC (apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like) overactivation; (b) multi-receptor tyrosine kinase inhibition with lenvatinib due to overexpression of FGFR1 (Fibroblast Growth Factor Receptor 1) and RET (Ret Proto-Oncogene) and, (c) later in the course of the disease, PARP (Poly(ADP-Ribose) Polymerase) inhibition with olaparib prompted by signs of defective homologous recombination DNA repair. In addition, our data provided new insights into the molecular landscape of PC with respect to the genome-wide footprints of specific mutational processes and pathogenic germline alterations. These data underscore the potential of comprehensive molecular analyses to improve care for patients with ultra-rare cancers based on insight into disease biology.


Original languageEnglish
Pages (from-to)1343-1355
Number of pages13
JournalMolecular oncology
Issue number7
Publication statusPublished - Jul 2023

External IDs

PubMedCentral PMC10323885
Scopus 85152429909
WOS 000969302500001
Mendeley a8021f17-c909-35a5-9954-c94889518eb2


Sustainable Development Goals


  • Humans, Parathyroid Neoplasms/drug therapy, Transcriptome/genetics, Mutation/genetics, Genomics/methods, Gene Expression Profiling/methods, Carcinoma/genetics, RNA sequencing, Mutational signature, Immune checkpoint inhibition, Whole-genome sequencing, Tyrosine kinase inhibition, Tumour mutational burden, whole-genome sequencing, tumour mutational burden, tyrosine kinase inhibition, mutational signature, immune checkpoint inhibition

Library keywords