Supplementary Material for: A Chromosome 9p24.1 Amplification in Colorectal Cancer with Metastases to the Kidney and Adrenal Gland: a Case Report

Colorectal cancer (CRC) is the third leading cause of mortality worldwide. The Food and Drug Administration recently designated pembrolizumab, an immune checkpoint inhibitor (ICI) against a programmed death-1 (PD-1) receptor, as a breakthrough drug for the treatment of patients with mCRC whose tumors have deficient mismatch repair gene (dMMR) expression (as evidenced by microsatellite instability-high [MSI-H]) and patients with solid tumors with a high tumor mutational burden (TMB-H) with ≥ 10 mutations/megabase. We present a patient with metastatic CRC who had renal and adrenal gland metastases with multiple genomic alterations characteristic of CRC and rare chromosome 9p24.1 amplification, resulting in a co-amplification of the PDL1, PDL2, and JAK2 genes. Although this genomic alteration may predict the response to ICI, the lack of pembrolizumab prevented the patient from receiving targeted treatment and succumbing to the disease.