scholarly journals Long-lasting response to afatinib that persisted after treatment discontinuation in a case ofEGFR-mutated lung adenocarcinoma

2019 ◽  
Vol 12 (1) ◽  
pp. e227383 ◽  
Author(s):  
Yumie Yamanaka ◽  
Yoshitaka Seki ◽  
Takeo Ishikawa ◽  
Kazuyoshi Kuwano
Keyword(s):  
Kinase Inhibitors ◽  
Growth Factor Receptor ◽  
Complete Response ◽  
Middle Lobe ◽  
Japanese Woman ◽  
Old Japanese ◽  
Exon 19 Deletion ◽  
History Of ◽  
Epidermal Growth ◽  
The Right

It is unknown whether tyrosine kinase inhibitors targeting epidermal growth factor receptor (EGFR) can be discontinued in patients in whomEGFR-mutated lung cancer has well stabilised. We present a case of a 73-year-old Japanese woman with no history of smoking. Right pulmonary lower lobectomy, lymph node dissection and segmental resection of the right middle lobe were performed. Additionally, she underwent adjuvant chemotherapy for stage IIIB adenocarcinoma harbouring anEGFRexon 19 deletion. Afatinib was administered for liver metastases after 15 months. A complete response of metastatic disease was achieved for 2 years. However, afatinib was unavoidably discontinued due to splenectomy for the treatment of idiopathic thrombocytopenic purpura. Although afatinib was not resumed, due to the abscess formation as surgery complication, a drug-free complete response was sustained for over 18 months. The present case suggests that exceptional and durable responses to afatinib can be achieved in individual cases.

scholarly journals Bone Metastasis of Non-Small-Cell Lung Cancer Showing Pathological Complete Response to Osimertinib Monotherapy

2021 ◽  
pp. 1876-1881
Author(s):  
Hiroshi Shintani ◽  
Shoji Oura ◽  
Tomoyuki Yamaguchi ◽  
Shinichiro Makimoto
Keyword(s):  
Lung Cancer ◽  
Bone Metastasis ◽  
Lung Adenocarcinoma ◽  
Kinase Inhibitors ◽  
Pathological Complete Response ◽  
Lung Nodule ◽  
Growth Factor Receptor ◽  
Complete Response ◽  
Pathological Examination ◽  
The Right

A 70-year-old man with lung adenocarcinoma had undergone right lower lobectomy and lymph node dissection. Only 6 months later under adjuvant uracil and futraful therapy, the patient developed a solitary bone metastasis in the right 8th rib. Due to positive mutation of epidermal growth factor receptor (EGFR) exon 21 L858R in the primary cancer, the patient received osimertinib monotherapy, leading to massive calcification of the osteolytic bone metastasis with significant decrease of standard uptake value on positron emission tomography. After 12 months of osimertinib monotherapy, slight enlargement of the ground glass nodule, i.e., presumed noninvasive lung cancer, in the right upper lobe, and no further occurrence of metastatic foci made us to resect both the lung nodule and the bone metastasis. Pathological examination showed the lung nodule to be noninvasive adenocarcinoma and the bone metastasis to have no viable cancer cells. The patient was discharged on the 8th postoperative day without any complication. On developing a therapeutic strategy for advanced/recurrent EGFR mutation-positive lung adenocarcinoma, oncologists should note the possibility of pathological complete response to newly developed EGFR tyrosine kinase inhibitors including osimertinib for a presumed cure of oligometastatic lung adenocarcinoma.

scholarly journals Achievement of Cure with Gefitinib in Advanced Lung Adenocarcinoma Harboring an Activating EGFR Mutation: A Case Report

2016 ◽  
Vol 9 (3) ◽  
pp. 565-567 ◽  
Author(s):  
Taiji Kuwata ◽  
Kazue Yoneda ◽  
Kenichi Kobayashi ◽  
Rintarou Oyama ◽  
Hiroki Matumiya ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Kinase Inhibitors ◽  
Growth Factor Receptor ◽  
Complete Response ◽  
Term Survival ◽  
Activating Mutations ◽  
First Case ◽  
Old Japanese ◽  
Gefitinib Treatment ◽  
Activating Egfr Mutation

Tyrosine kinase inhibitors (TKIs) of the epidermal growth factor receptor (EGFR) may achieve long-term survival in selected cases with advanced non-small cell lung cancer harboring activating mutations in the EGFR gene, but a cured case has not been reported yet. Here, we present the first case of EGFR-mutated lung adenocarcinoma cured with an EGFR-TKI, as the 75-year-old Japanese man has achieved complete response with gefitinib treatment and has survived without tumor 10 years after termination of gefitinib treatment.

scholarly journals Cryptococcal Endocarditis in a Woman with Metastatic Non-Small Cell Lung Cancer: A Case Report and Review of the Literature

2020 ◽  
pp. 1-5
Author(s):  
Tony Kurian ◽  
Tony Kurian ◽  
Jason Peng ◽  
Courtney Regan Wagner ◽  
Fritzie S. Albarillo
Keyword(s):  
Kinase Inhibitors ◽  
Small Cell Lung Carcinoma ◽  
Growth Factor Receptor ◽  
Progression Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Replacement Surgery ◽  
History Of ◽  
Epidermal Growth

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have demonstrated improved progression-free survival benefits and decreased treatment-related side effects, and therefore are now considered first-line of treatment of EGFR mutated, metastatic non-small cell lung carcinoma (NSCLC). Cryptococcal endocarditis is an extremely rare clinical entity with only seven reported cases in the literature. Prior cases were seen in patients with a history of rheumatic heart disease or prior valve replacement surgery. Little is known regarding the natural history and optimal management of Cryptococcal endocarditis, given the limited available data. We present a case of Cryptococcal endocarditis and meningitis in a patient with metastatic NSCLC receiving targeted therapy with an EGFR-TKI with no history of significant cardiac disease.

scholarly journals Amyloidosis in the Palpebral Conjunctiva Mimicking Lymphoproliferative Lesion

2021 ◽  
pp. 73-76
Author(s):  
Shinjiro Kono ◽  
Patricia Ann L. Lee ◽  
Hirohiko Kakizaki ◽  
Yasuhiro Takahashi
Keyword(s):  
Differential Diagnosis ◽  
Japanese Woman ◽  
Soft Tissue Lesion ◽  
Palpebral Conjunctiva ◽  
Biopsy Specimens ◽  
Body Sensation ◽  
Old Japanese ◽  
History Of ◽  
The Right ◽  
Conjunctival Lesion

A 47-year-old Japanese woman presented with a 1-year history of foreign body sensation in the right eye. Upon examination, a linear soft tissue lesion in the lower conjunctival fornix was noted. The mass resembled a conjunctival lymphoproliferative lesion but was pinkish-yellow rather than salmon pink in color. Histopathology of the biopsy specimens revealed amyloidosis. Systemic workup showed no other lesions. The conjunctival lesion did not recur at 3 months postoperatively. Since conjunctival amyloidosis mimics conjunctival lymphoproliferative lesions, it is important to keep conjunctival amyloidosis as a differential diagnosis in the diagnosis of a pinkish conjunctival lesion.

scholarly journals Successful Erlotinib Treatment for a Patient with Gefitinib-Related Hepatotoxicity and Lung Adenocarcinoma Refractory to Intermittently Administered Gefitinib

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Tatsuya Nagano ◽  
Yoshikazu Kotani ◽  
Kazuyuki Kobayashi ◽  
Masahiro Katsurada ◽  
Yukihisa Hatakeyama ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Liver Toxicity ◽  
Growth Factor Receptor ◽  
Treatment Schedule ◽  
Hepatic Enzyme ◽  
Intermittent Treatment ◽  
Old Japanese ◽  
Exon 19 Deletion ◽  
Epidermal Growth ◽  
Exon 19

A 73-year-old Japanese man was histologically diagnosed with lung adenocarcinoma harboring an exon 19 deletion in the epidermal growth factor receptor. The patient was treated with gefitinib for 6 weeks until he developed substantially elevated hepatic enzyme levels that resulted in the discontinuation of gefitinib. Gefitinib was reintroduced with an intermittent treatment schedule after the transaminase levels normalized, but the patient's enzyme levels rose again, and the cancer progressed. Gefitinib was eventually replaced with erlotinib. There was stable disease for 7 weeks without any signs of liver toxicity. Thus, erlotinib may be a beneficial and well-tolerated treatment option for patients with gefitinib-related hepatotoxicity.

Efficacy of afatinib treatment for lung adenocarcinoma harboring exon 18 delE709_T710insD mutation

2019 ◽  
Vol 49 (8) ◽  
pp. 786-788 ◽  
Author(s):  
Yoshitaka Iwamoto ◽  
Eiki Ichihara ◽  
Naofumi Hara ◽  
Takamasa Nakasuka ◽  
Chihiro Ando ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Kinase Inhibitors ◽  
Growth Factor Receptor ◽  
Next Generation ◽  
Alk Rearrangement ◽  
Rare Mutation ◽  
Egfr Tyrosine Kinase Inhibitors ◽  
History Of ◽  
Epidermal Growth ◽  
Generation Sequencing

Abstract Exon 18 delE709_T710insD is an extremely rare mutation in epidermal growth factor receptor (EGFR) in non-small-cell lung cancer (NSCLC); the efficacy of EGFR tyrosine kinase inhibitors against this mutation remains unclear. In this case report, we report a case of NSCLC harboring EGFR exon 18 delE709_T710insD that was not detected by a commercially available assay, but was detected by a next-generation sequencing cancer panel. A 56-year old female patient with advanced NSCLC was diagnosed as EGFR-mutation-negative using the PNAClamp method. ALK rearrangement was also absent and she received cytotoxic chemotherapies. Clinical characteristics, including adenocarcinoma histology and no history of smoking, implied the presence of a driver mutation, so a next-generation-sequencing Oncomine® Cancer Research Panel was conducted in the patient’s clinical course and the EGFR exon 18 delE709_T710insD mutation was detected. The patient started afatinib as sixth-line treatment and her pulmonary lesion significantly decreased in size. Afatinib was continued for 7 months until disease progressed.

Prophylactic cranial irradiation after reaching complete response, partial response, or stable disease in non-small cell lung cancer patients treated with epidermal growth factor receptor tyrosine kinase inhibitors (ProACT).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. TPS7617-TPS7617
Author(s):  
Amanda Tufman ◽  
Claus Belka ◽  
Heike Kuenzel ◽  
Rudolf M. Huber
Keyword(s):  
Kinase Inhibitors ◽  
Growth Factor Receptor ◽  
Stage Iv ◽  
Complete Response ◽  
Cranial Irradiation ◽  
Prophylactic Cranial Irradiation ◽  
Epidermal Growth ◽  
Nsclc Patients ◽  
Egfr Tkis

TPS7617 Background: Patients with non-small cell lung cancer (NSCLC) who respond to treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) seem to be at increased risk of central nervous system relapse, and may benefit from prophylactic cranial irradiation (PCI) more than other NSCLC patients. Methods: This study investigates the safety and efficacy of combining PCI with EGFR TKIs in stage IV NSCLC. Patients with stage IV NSCLC, no evidence of brain metastases, and an indication for first or later line therapy with an EGFR TKI will be enrolled. Those with complete response (CR), partial response (PR), or stable disease (SD) following 6 weeks of therapy and no evidence of brain metastases on MRI will be treated with PCI. Neurocognitive function, depression indices, quality of life, symptoms, and ability to function independantly will be assessed at baseline, before PCI, and at 6 week and then 3 month intervals following PCI. MRI will be repeated 6 weeks following PCI and at 3 month intervals, and serum markers of blood brain barrier permeability (neuron-specific enolase (NSE), protein S100 beta) will be assessed at all visits. Safety data will be formally reviewed after the first 10 patients. The primary endpoint for efficacy is overall survival. Secondary endpoints include progression free survival, site of progression, quality of life and neurological disability. Planed subgroup analyses based on mutation status, line of treatment with TKIs, comorbidity, precise histology and molecular biology will be carried out.

scholarly journals Lung adenocarcinoma concomitant with xeroderma pigmentosum: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Masataka Matsumoto ◽  
Kazumi Kaneshiro ◽  
Kiyonobu Takatsuki
Keyword(s):  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Side Effects ◽  
Epidermal Growth Factor ◽  
Lung Adenocarcinoma ◽  
Xeroderma Pigmentosum ◽  
Growth Factor Receptor ◽  
Consanguineous Marriage ◽  
History Of ◽  
Epidermal Growth

Abstract Background Xeroderma pigmentosum is a rare, autosomal-recessive photosensitive dermatosis. Patients with xeroderma pigmentosum have an impaired ability to repair deoxyribonucleic acid damage caused by ultraviolet rays, resulting in skin cancer. Patients with xeroderma pigmentosum are more susceptible to some cancers. We herein report a case of xeroderma pigmentosum accompanied by lung cancer. Case presentation The patient was a Japanese woman in her 70s with a family history of consanguineous marriage. Her medical history included squamous cell carcinoma and basal cell carcinoma, in addition to xeroderma pigmentosum. She presented with dry skin with small, pigmented spots, which were particularly focused around the areas exposed to sunlight. Chest computed tomography was conducted to assess for any evidence of metastatic skin carcinoma, and revealed a tumor in the left upper subpleural lobe of the lung. Consequently, she was referred to our department. Finally, we diagnosed lung adenocarcinoma (pT2aN0M1b: stage IVA). She had an epidermal growth factor receptor (EGFR) mutation (p.L858R). Treatment with an epidermal growth factor receptor tyrosine kinase inhibitor (gefitinib) was initiated, and the tumor gradually regressed. No side effects were observed. However, she later died from aspiration pneumonia. Conclusions Although xeroderma pigmentosum is rare, a history of consanguineous marriage should be verified. Because of the severe side effects of cisplatin and radiotherapy in xeroderma pigmentosum patients, the risks and benefits of treatment should be considered thoroughly.

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