| Summary: | A 78-year-old man was referred to the oncology clinic with a cervical esophageal squamous cell cancer completely obstructing the esophagus. Due to concerns for tracheal invasion, we were not able to offer potentially curative chemoradiotherapy and only palliative chemotherapy was recommended. Genomic profiling of the tumor revealed a BRCA1 mutation. Because BRCA1 is needed for DNA double strand break repair, a platinum-based agent was used in the hope that it would create double strand breaks, and thus be synthetically lethal in the BRCA-deficient cancer cells. The patient was treated with oxaliplatin and 5-fluorouracil plus leucovorin chemotherapy. After four cycles of treatment, he achieved a complete clinical response with no disease noted on PET or EGD, and he regained the ability to swallow again. This case demonstrates the susceptibility of BRCA-deficient cancers to platinum-based agents and reifies the potential for synthetic lethality in cancer treatment.
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