Rapid resolution of choroidal metastatic tumour secondary to lung cancer following treatment with alectinib

2021 ◽  
Vol 14 (5) ◽  
pp. e238573
Author(s):  
Ahmed AL-Janabi ◽  
May Thu Han ◽  
Deborah Busby ◽  
Benjamin J L Burton
Keyword(s):  
Lung Cancer ◽  
Kinase Inhibitor ◽  
Subretinal Fluid ◽  
Distant Metastases ◽  
Metastatic Tumour ◽  
Abnormal Liver Function Test ◽  
Rapid Resolution ◽  
Patient Reported ◽  
The Right ◽  
Ocular Safety

A 64-year-old man presented with reduced vision in the right eye (visual acuity of 6/24 Snellen). The patient reported having a chronic cough and recent weight loss with difficulty in swallowing and abnormal liver function test 8 months prior to his presentation. He was a chronic smoker for 45 years, having quit a year earlier. Fundus examination showed a unifocal large yellow–brown subretinal mass involving the posterior segment of the eye and associated with subretinal fluid. The patient was diagnosed with a choroidal metastasis and was referred urgently to the oncology team who confirmed the presence of non-small cell lung cancer with distant metastases. He started treatment with alectinib (second-generation tyrosine kinase inhibitor). A few weeks later, his vision improved and, on examination, there was complete resolution of the choroidal mass and the associated subretinal fluid. Alectinib led to rapid resolution of his choroidal secondary and has excellent ocular safety profile.

scholarly journals EGFR Genotyping of Matched Urine, Plasma, and Tumor Tissue in Patients With Non–Small-Cell Lung Cancer Treated With Rociletinib, an EGFR Tyrosine Kinase Inhibitor

2018 ◽  
pp. 1-13 ◽  
Author(s):  
Jonathan W. Goldman ◽  
Chris Karlovich ◽  
Lecia V. Sequist ◽  
Vlada Melnikova ◽  
Aleksandra Franovic ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Kinase Inhibitor ◽  
Objective Response ◽  
Distant Metastases ◽  
Small Cell ◽  
Attractive Alternative ◽  
Small Cell Lung ◽  
Liquid Biopsies

Purpose Liquid biopsies represent an attractive alternative to tissue biopsies, particularly rebiopsies, in determining patient eligibility for targeted therapies. Clinical utility of urine genotyping, however, has not been explored extensively. We evaluated epidermal growth factor receptor ( EGFR) T790M detection in matched urine, plasma, and tissue and the clinical outcomes of patients with advanced non–small-cell lung cancer treated with rociletinib. Methods Tissue (n = 540), plasma (n = 482), and urine (n = 213) were collected from evaluable patients enrolled in TIGER-X, a phase I/II study. Genotyping was performed by therascreen EGFR testing in tissue, BEAMing in plasma, and a quantitative short footprint assay (Trovera) in urine, which was used to further examine discordant samples. Results Positive percent agreement with tissue T790M results was similar for urine (82%; 142 of 173) and plasma (81%; 313 of 387) genotyping. Urine and plasma together identified more patients who were T790M positive (92%) than tissue alone (83%) among matched samples (n = 177). The ability to identify mutations in plasma was strongly associated with M stage ( P < .001); rate of T790M detection for patients with M1a/M0 disease increased from 54% for plasma alone to 85% when urine and plasma were both examined. Objective response rates of patients who were T790M positive were comparable between tumor (34%), plasma (32%), and urine (37%). Conclusion Clinical response to rociletinib was comparable irrespective of whether T790M status was identified by liquid or tissue biopsy. Combined, urine and plasma identified a higher percentage of patients who were T790M positive than tumor genotyping alone and improved detection of T790M, particularly in the absence of distant metastases. These findings support the noninvasive analysis of urine and plasma before tumor rebiopsy when assessing T790M status.

scholarly journals Stage 4 Lung Cancer with Brain and Pericardial Metastases Which Are First Considered as Pulmonary Tuberculosis Infection and Heart Failure

2020 ◽  
Vol 16 (2) ◽  
pp. 127
Author(s):  
Haryati Haryati ◽  
Marsheilla Riska
Keyword(s):  
Lung Cancer ◽  
Pericardial Effusion ◽  
Pulmonary Tuberculosis ◽  
Tyrosine Kinase ◽  
Ct Scan ◽  
Kinase Inhibitor ◽  
Clinical Symptoms ◽  
Egfr Mutations ◽  
Contrast Enhanced Ct ◽  
Patient Reported

Abstract: Lung cancer and pulmonary tuberculosis become a global problem in the world. The similarities of clinical symptoms and radiological appearances often complicates diagnosis especially in TB endemic countries. A 43-year-old man presented with shortness of breath for 6 months, accompanied by intermittent cough mixed with blood streaks. He had been taking anti-tuberculosis for 2 months, but there’s no improvement. On physical examination, ronchi were heard in the lower 2/3 of the right lung and heart sounds diminished. Motoric movement of the left hand was difficult to grasp hard. A contrast-enhanced CT scan of the head revealed hyperdense multiple nodules. Chest X-ray showed cardiomegaly with right lung consolidation and a primary malignant right lung mass accompanied by pericardial effusion at thoracic CT scan. Cytology and EGFR examination of pericardial effusion found adenocarcinoma metastasis with exon 18 and 21 mutations. Evaluation of clinical symptoms and radiological examination during tyrosine kinase inhibitor (TKI) therapy showed improvement. Lung cancer can resemble pulmonary tuberculosis in various manifestations. Adenocarcinoma with positive EGFR mutations is more commonly found in Asians. Cytology and EGFR examination of pericardial effusion became the basis of diagnosis in this case. He was given TKI therapy. Re-evaluation must be carried out in patients who do not improve with antibiotics or anti-tuberculosis. Patient reported a good response after consuming EGFR-TKI. Keywords: lung cancer, tuberculosis, tyrosine kinase inhibitors

Presumed Choroidal Metastasis From Oncocytic Carcinoma of the Parotid Gland: A Case Report

2019 ◽  
Vol 4 (3) ◽  
pp. 253-256
Author(s):  
Yousef J. Cruz-Iñigo ◽  
Stephen A.M. De Souza
Keyword(s):  
Parotid Gland ◽  
External Beam Radiotherapy ◽  
Subretinal Fluid ◽  
Malignant Neoplasm ◽  
Distant Metastases ◽  
Choroidal Metastasis ◽  
Current Case ◽  
Oncocytic Carcinoma ◽  
History Of ◽  
The Right

Purpose: This article reports a case of presumed choroidal metastasis from an oncocytic carcinoma of the parotid gland. Methods: A 70-year-old man with history of an oncocytic carcinoma of the parotid gland presented owing to a 1-month history of progressive blurred central vision shortly after metastatic surveillance workup revealed liver, lung, and spine metastases. Fundus examination of the right eye showed a yellow choroidal mass surrounding the optic nerve and extending inferonasally, which is associated with subretinal fluid involving the foveal center. A-scan and B-scan ultrasonography were remarkable for a dome-shaped choroidal mass with medium-to-high internal reflectivity. Fluorescein angiography revealed pinpoint foci of hyperfluorescence over the choroidal lesion with late leakage. Magnetic resonance imaging of the brain showed evidence of metastatic disease to the cerebellum. While the patient underwent systemic chemotherapy, external beam radiotherapy was used to treat the eye. Results: Four months later, visual acuity improved, the tumor reduced in size, and the subretinal fluid resolved. Systemic workup disclosed no new metastases. Conclusion: Oncocytic carcinoma of the parotid gland is a rare and aggressive malignant neoplasm with frequent recurrences and distant metastases. The current case suggests that oncocytic carcinoma can metastasize to the choroid and, consequently, ocular metastasis surveillance is advised in these patients.

Assessment of knowledge of oral health hygiene among coastal guards in the port trust of south Tamil Nadu - A public health awareness survey

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1861-1868
Author(s):  
Bianca Princeton ◽  
Abilasha R ◽  
Preetha S
Keyword(s):  
Lung Cancer ◽  
Oral Health ◽  
Oral Hygiene ◽  
Tamil Nadu ◽  
Asbestos Exposure ◽  
The Other ◽  
Oral Manifestations ◽  
Illegal Activities ◽  
The Right ◽  
Oral Hygiene Habits

Oral hygiene is defined as the practice of keeping the mouth clean and healthy, by brushing and flossing to prevent the occurrence of any gum diseases like periodontitis or gingivitis. The main aim of oral health hygiene is to prevent the buildup of plaque, which is defined as a sticky film of bacteria and food formed on the teeth. The coastal guard is an official who is employed to watch the sea near a coast for ships that are in danger or involved with illegal activities. Coastal guards have high possibilities of being affected by mesothelioma or lung cancer due to asbestos exposure. So, a questionnaire consisting of 20 questions was created and circulated among a hundred participants who were coastal guards, through Google forms. The responses were recorded and tabulated in the form of bar graphs. Out of a hundred participants, 52.4% were not aware of the fact that coastal guards have high chances of developing lung cancer and Mesothelioma. 53.7% were aware of the other oral manifestations of lung cancer other than bleeding gums. Majority of the coastal guards feel that they are given enough information about dental hygiene protocols. Hence, to conclude, oral hygiene habits have to be elaborated using various tools in the right manner to ensure better health of teeth and gums.

Selecting a PRO-CTCAE based subset for patient reported symptom monitoring during lung cancer treatment (Preprint)

2020 ◽  
Author(s):  
Evalien Veldhuijzen ◽  
Iris Walraven ◽  
Jose Belderbos
Keyword(s):  
Lung Cancer ◽  
Clinical Practice ◽  
Cancer Patients ◽  
Treatment Modalities ◽  
European Organization ◽  
Specific Patient ◽  
Symptom Monitoring ◽  
Lung Cancer Patients ◽  
Wide Range ◽  
Patient Reported

BACKGROUND The Patient Reported Outcomes Version of the Common Terminology Criteria of Adverse Events (PRO-CTCAE) item library covers a wide range of symptoms relevant for oncology care. To enable implementation of PRO-CTCAE-based symptom monitoring in clinical practice, there is a need to select a subset of items relevant for specific patient populations. OBJECTIVE The aim of this study was to develop a PRO-CTCAE subset relevant for patients with lung cancer. METHODS The PRO-CTCAE-based subset for lung cancer patients was generated using a mixed methods approach based on the European Organization for Research and Treatment of Cancer (EORTC) guidelines for developing questionnaires, consisting of a literature review and semi-structured interviews with both lung cancer patients and health care practitioners (HCPs). Both patients and HCPs were queried on the relevance and impact of all PRO-CTCAE items. Results were summarized and, after a final round of expert review, a selection of clinically relevant items for lung cancer patients was made. RESULTS A heterogeneous group of lung cancer patients (n=25) from different treatment modalities and HCPs (n=22) participated in the study. A final list of eight relevant PRO-CTCAE items was created: decreased appetite, cough, shortness of breath, fatigue, constipation, nausea, sadness, and pain (general). CONCLUSIONS Based on literature and both professional and patient input, a subset of PRO-CTCAE items has been identified for use in lung cancer patients in clinical practice. Future work is needed to confirm the validity and effectiveness of this PRO-CTCAE lung cancer subset internationally, and in the real-world clinical practice setting.

scholarly journals Patients with Metastatic Lung Cancer and Oncologists’ Views on Achievement of Treatment Goals and Making the Right Treatment Decision: A Prospective Multicenter Study

2021 ◽  
pp. 0272989X2199895
Author(s):  
Adinda Mieras ◽  
Annemarie Becker-Commissaris ◽  
Hanna T. Klop ◽  
H. Roeline W. Pasman ◽  
Denise de Jong ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Multicenter Study ◽  
Systemic Treatment ◽  
Treatment Decision ◽  
Treatment Goals ◽  
Metastatic Lung Cancer ◽  
Prospective Multicenter Study ◽  
Cancer Data ◽  
Metastatic Lung ◽  
The Right

Background Previous studies have investigated patients’ treatment goals before starting a treatment for metastatic lung cancer. Data on the evaluation of treatment goals are lacking. Aim To determine if patients with metastatic lung cancer and their oncologists perceive the treatment goals they defined at the start of systemic treatment as achieved after treatment and if in hindsight they believe it was the right decision to start systemic therapy. Design and Participants A prospective multicenter study in 6 hospitals across the Netherlands between 2016 and 2018. Following systemic treatment, 146 patients with metastatic lung cancer and 23 oncologists completed a questionnaire on the achievement of their treatment goals and whether they made the right treatment decision. Additional interviews with 15 patients and 5 oncologists were conducted. Results According to patients and oncologists, treatment goals were achieved in 30% and 37% for ‘quality of life,’ 49% and 41% for ‘life prolongation,’ 26% and 44% for ‘decrease in tumor size,’ and 44% for ‘cure’, respectively. Most patients and oncologists, in hindsight, felt they had made the right decision to start treatment and also if they had not achieved their goals (72% and 93%). This was related to the feeling that they had to do ‘something.’ Conclusions Before deciding on treatment, the treatment options, including their benefits and side effects, and the goals patients have should be discussed. It is key that these discussions include not only systemic treatment but also palliative care as effective options for doing ‘something.’

scholarly journals EML4-ALK positive lung adenocarcinoma with skeletal muscle metastasis in the right calf which was treatable with lorlatinib after resistance to treatment with alectinib

2021 ◽  
Vol 14 (4) ◽  
pp. e240295
Author(s):  
Hironari Matsuda ◽  
Munechika Hara ◽  
Shin-Ichiro Iwakami ◽  
Kazuhisa Takahashi
Keyword(s):  
Skeletal Muscle ◽  
Lung Adenocarcinoma ◽  
Kinase Inhibitor ◽  
Stable Condition ◽  
Japanese Woman ◽  
Alk Rearrangement ◽  
Anaplastic Lymphoma ◽  
Resistance To Treatment ◽  
Alk Positive ◽  
The Right

This report concerns a patient with skeletal muscle metastases due to lung adenocarcinoma harbouring an echinoderm microtubule-associated protein-like-4 (EML4)-anaplastic lymphoma kinase (ALK) rearrangement, who was successfully treated with lorlatinib after resistance to alectinib. A right lower lobectomy based on a diagnosis of lung adenocarcinoma was performed on a 77-year-old Japanese woman. After 7 months of surgical resection, a mass in the right calf was observed. A fine-needle aspiration biopsy from the mass was performed and the mass was diagnosed as metastatic adenocarcinoma harbouring EML4-ALK rearrangement. Alectinib was administered for 10 months. Then, administration of lorlatinib, an ALK tyrosine kinase inhibitor classified as third generation, was initiated after resistance to treatment with alectinib. After starting treatment with lorlatinib, the gastrocnemius tumour diminished and has maintained a stable condition. Our case suggests that EML4-ALK positive lung adenocarcinoma is treatable with lorlatinib after resistance to treatment with alectinib.

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