scholarly journals Dramatic Response of a Metastatic Primary Small-Cell Carcinoma of the Pancreas to a Trial of Immunotherapy with Nivolumab: A Case Report

2017 ◽  
Vol 10 (2) ◽  
pp. 720-725 ◽  
Author(s):  
Justin Kenneth Ugwu ◽  
Chiemeziem Nwanyanwu ◽  
Abhay Ramchandra Shelke
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Checkpoint Inhibitors ◽  
Positive Outcome ◽  
Small Cell ◽  
Small Cell Lung ◽  
Durable Response ◽  
Neuroendocrine Cancer ◽  
Cancer Of The Pancreas ◽  
Neuroendocrine Cancers

Extrapulmonary small-cell neuroendocrine cancers are rare in clinical practice. They are frequently metastatic at the time of diagnosis with survival in months even with the most intensive treatment. So far, treatment recommendations for this group rely on data from the similar but more common small-cell carcinoma of the lungs. Immune checkpoint inhibitors are being investigated for the treatment of metastatic small-cell lung cancer with positive outcome. We applied the experience from these studies to a case of metastatic small-cell neuroendocrine cancer of the pancreas using nivolumab as a treatment of last resort. We noted a favorable and durable response suggesting that this may be superior to all currently available options for palliative treatment in a similar scenario.

Response with pemrbolizumab in a patient with EGFR mutated non-small cell lung cancer harbouring insertion mutations in V834L and L858R

2021 ◽  
pp. 107815522110578
Author(s):  
Matthew J. Hadfield ◽  
Alla Turshudzhyan ◽  
Khalid Shalaby ◽  
Aswanth Reddy
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Kinase Inhibitors ◽  
Checkpoint Inhibitors ◽  
Small Cell ◽  
Egfr Mutations ◽  
Small Cell Lung ◽  
Durable Response ◽  
Egfr Mutated

Introduction Lung cancer is the leading cause of cancer-related deaths with non-small cell lung cancer (NSCLC) being the most common of them. About a third of NSCLC cases have an epidermal growth factor (EGFR) mutation, which is usually susceptible to tyrosine kinase inhibitors (TKIs). In rare cases where patients progress through TKI therapy, the use of immune checkpoint inhibitors (ICIs) remains controversial. Case report We describe a case of a patient with significant history of smoking and EGFR mutated programmed death ligand-1 (PD-L1) positive NSCLC who was initially treated with TKI therapy. Management/Outcome While patient progressed on TKI therapy, he was able to achieve a durable response with a single PD-L1 agent, pembrolizumab. Contrary to the available evidence, the presented EGFR mutant NSCLC responded to PD-L1 pathway inhibition. Discussion From our observation Pembrolizumab could be promising in patients with rare EGFR mutations who do not respond to EGFR directed therapy. Our report provides supporting data for the use of immunotherapies in patients with EGFR mutated NSCLC.

A phase II study of atezolizumab and cobimetinib in PD-1/PD-L1 inhibitor resistant or refractory non-small cell lung cancer: ETCTN #10166.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. TPS9638-TPS9638
Author(s):  
Stephen V. Liu ◽  
Richard Delmar Hall ◽  
Andreas Nicholas Saltos ◽  
Gregory Alan Otterson ◽  
Ming Tony Tan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Phase Ii ◽  
Response Rate ◽  
Phase Ii Study ◽  
Checkpoint Inhibitors ◽  
Small Cell ◽  
Small Cell Lung ◽  
Primary Resistance ◽  
Durable Response

TPS9638 Background: Use of checkpoint inhibitors, alone or with chemotherapy, has emerged as the preferred standard treatment for patients with advanced, driver-negative non-small cell lung cancer (NSCLC). While outcomes are superior to chemotherapy alone, only a subset of patients achieve durable response and long term survival. One potential mechanism of primary resistance to checkpoint inhibitors is the lack of tumor-infiltrating lymphocytes. Inhibition of mitogen-activated protein kinase (MAPK) kinase (MEK) increases the number of CD8+ T-cell within a tumor and has shown synergy with anti-programmed death-ligand 1 (PD-L1) antibodies. The combination of the MEK inhibitor cobimetinib and the PD-L1 antibody atezolizumab has led to limited responses in colorectal cancer, a tumor typically non-responsive to checkpoint inhibition. This phase II trial explores the combination of cobimetinib and atezolizumab in patients with PD(L)1-refractory NSCLC. Methods: This phase II study is being conducted through the Experimental Therapeutics Clinical Trials Network (ETCTN #10166). Eligible patients have advanced NSCLC with primary resistance to anti-PD(L)1 therapy (defined as progression noted within 6 months of initiating therapy) and tumor amenable to serial core biopsy. Patients will receive atezolizumab 840mg intravenously every 2 weeks and cobimetinib 60mg orally for 21 days in 28-day cycles. Two cohorts will enroll in parallel, defined by presence or absence of a KRAS mutation. Each cohort will employ a Simon two-stage design to test a null rate of 5% vs. 25% (power = 0.90, □ = 0.10). If > 1 of 9 patients in stage 1 achieve a partial response, an additional 15 patients are enrolled and if > 3 patients achieve a durable response, the combination will be worthy of further investigation. The primary endpoint is durable (> 6 months) response rate. Secondary endpoints are overall response rate, progression free survival, overall survival, duration of response and adverse events. Biopsies performed at baseline and after 3 weeks of therapy will assess the change in the density of tumoral CD8+ T-cells. Whole exome sequencing and immune cell profiling will also be performed on serial samples. Enrollment was initially limited to KRAS-mutant NSCLC. Prespecified activity goal for the first stage of accrual has been met; second stage accrual began in September 2019. Enrollment to the KRAS wild-type cohort will commence. Clinical trial information: NCT03600701 .

scholarly journals Pathological analysis of hesperetin-derived small cell lung cancer by artificial intelligence technology under fiberoptic bronchoscopy

2021 ◽  
Vol 18 (6) ◽  
pp. 8538-8558
Author(s):  
Xiaoli Zhang ◽  
◽  
Ziying Yu ◽  
Keyword(s):  
Artificial Intelligence ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Cell Lung Cancer ◽  
Fiberoptic Bronchoscopy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Artificial Intelligence Technology

<abstract> <p>Lung cancer is one of the most common tumors. There are 1.8 million new cases worldwide each year, accounting for about 13% of all new tumors. Lung cancer is the most important cause of cancer-related deaths. 1.4 million people die of lung cancer each year. This article uses artificial intelligence technology to analyze the pathology of hesperetin-derived small cell lung cancer under fiberoptic bronchoscopy. This article takes 48 lung slice samples as the research object. Among them, 36 cases of lung small cell carcinoma have history slices from Lhasa City Institute of Biology, the patient has complete cases, and the other 12 normal lung slices come from Xinjiang Biotechnology Laboratory. In this paper, the above-mentioned 36 lung cancer slices became the study group, and 12 normal slices became the reference group. This article presents a method for hesperetin-fiber bronchoscope to study the pathological mechanism of lung small cell carcinoma (H-FBS), which is used to study slices. The above-mentioned 48 samples were taken for slice observation. First, the 48 slices were technically tested by artificial intelligence fiber bronchoscope combined with hesperetin derivatives, and then the slice observation results were verified by CTC technology. In addition, in each step, the C5orf34 in the tissue is detected separately, which is beneficial to adjust the content of C5orf34 so that the treatment of lung cancer can control the development of lung cancer under fiberoptic bronchoscopy. Experimental results show that the diagnostic accuracy rate of this method is 97.9%, which is higher than that of lung biopsy (89%); compared with multiple CTC detection, the cost is low and the time is shor.</p> </abstract>

scholarly journals Changing trends in incidence of lung cancer by histological type in Montenegro

2014 ◽  
Vol 142 (1-2) ◽  
pp. 23-28
Author(s):  
Milic Medenica ◽  
Miras Medenica ◽  
Olivera Bojovic ◽  
Ivan Soldatovic ◽  
Ivana Durutovic
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Histological Type ◽  
Small Cell Lung

Introduction. Lung cancer is one of the most common malignant neoplasms, as well as the most common cause of death cancer. Most lung cancers are squamous cell carcinomas, small cell carcinomas or adenocarcinomas. Objective. Examining changes in trends of lung cancer incidence in Montenegro by histological type during a 15-year period, from 1997 to 2011. Methods. During the study period, histopathological confirmation was obtained for all primary lung cancer cases in the only hospital for lung diseases in the country. Based on the data from medical records, patients were classified by time period, sex, age groups and smoking history. Descriptive method was used. Results. Ratio between incidences of adenocarcinoma and squamous cell carcinoma changes in males, with a significant increase in the incidence rate of adenocarcinoma and drop in the rate of squamous cell carcinoma (p<0.001). In addition, statistically significant (p<0.05) decrease in the incidence of NSCLC (non-small cell lung cancer) and an increase in the incidence of SCLC (small cell lung cancer) was found. A statistically significant increase in linear trend in the incidence of small cell carcinoma was noted in females (p<0.005). Conclusion. Incidence rates of adenocarcinoma and small cell carcinoma have increased during the study period.

A case report of dermatomyositis associated with small cell lung cancer

2012 ◽  
Vol 98 (6) ◽  
pp. e158-e161 ◽  
Author(s):  
Wha-Yong Lee ◽  
Jack Kastelik ◽  
Anne Campbell ◽  
Ged Avery ◽  
Damian McGivern ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Cell Lung Cancer ◽  
Poor Prognosis ◽  
Small Cell ◽  
Small Cell Lung

Dermatomyositis associated with lung cancer is uncommon. Dermatomyositis associated with small cell lung cancer is very rare and carries a poor prognosis. We present a case of a patient with dermatomyositis associated with small cell carcinoma of the lung and review the literature.

Small cell carcinoma of bladder: A single-center prospective study of 25 cases treated in analogy to small cell lung cancer

Urology ◽  
2005 ◽  
Vol 65 (2) ◽  
pp. 295-299 ◽  
Author(s):  
Axel Bex ◽  
Jakko A. Nieuwenhuijzen ◽  
Martijn Kerst ◽  
Floris Pos ◽  
Hester van Boven ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prospective Study ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Single Center ◽  
Small Cell Lung

Molecular profiling of small cell lung cancers in Japanese patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7599-7599
Author(s):  
Kazushige Wakuda ◽  
Hirotsugu Kenmotsu ◽  
Masakuni Serizawa ◽  
Yasuhiro Koh ◽  
Mitsuhiro Isaka ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Patient Characteristics ◽  
Molecular Profiling ◽  
Small Cell ◽  
Driver Mutations ◽  
Small Cell Lung ◽  
Lung Cancers ◽  
Pik3ca Amplification ◽  
Combined Small Cell Carcinoma

7599 Background: Molecular abnormalities discovered in the last decade have led to a paradigm shift in the diagnosis and treatment of lung adenocarcinoma. But there have been few reports about molecular profiling of small cell lung cancers (SCLC). We conducted the Shizuoka Lung Cancer Mutation Study to analyze driver mutations in patients with thoracic SCLC malignancies. Methods: We collected molecular profiling data of SCLC from the biobanking system in conjunction with the clinic, including the pathology lab, where 23 mutations in 9 genes (EGFR, KRAS, BRAF, PIK3CA, NRAS, MEK1, AKT1, PTEN and HER2), EGFR, MET, PIK3CA, FGFR1 and FGFR2 amplifications, and EML4-ALK translocations were assessed using pyrosequensing plus capillary electrophoresis, qRT-PCR, and RT-PCR, respectively. To evaluate mutation status for SCLC patients, we collected patient characteristics data from medical records. Results: Between July 2011 and July 2012, fifty small cell lung cancer patients were assessed in our biobanking system. Patient characteristics were as follows: median age (range) 70 (43 - 82) years; male 82%; smoker 96%; limited disease/extended disease 56/44%; small cell carcinoma/combined small cell carcinoma with adenocarcinoma 94/6%; surgically resected snap-frozen samples 8, formalin-fixed paraffin-embedded samples 40 and pleural effusion 7. We detected driver mutations in 8 cases (16%). Mutations found: EGFR 1 (2%), KRAS 1 (2%), PIK3CA 2 (4%), AKT1 1 (2%), MET amplification 1 (2%), PIK3CA amplification 6 (12%). EGFR and KRAS mutation were found in combined small cell carcinoma with adenocarcinoma. No significant differences in age, sex, disease extent at diagnosis or smoking status were found between patients with mutations and those without mutations. But serum neuron-specific enolase (NSE) levels were significantly higher in patients without mutations (p=0.03). Conclusions: In our analysis, driver mutations were found in 16% of SCLC patients and PIK3CA amplification seemed to be relatively frequent in SCLC. Our results suggest that PIK3CA might become a target of treatment for SCLC patients.

Programmed death-ligand 1 (PD-L1) expression in small cell carcinoma of bladder.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16019-e16019
Author(s):  
Angela Sanguino ◽  
Arash Samiei ◽  
Gurleen Pasricha ◽  
Lakshmi Harinath ◽  
Ralph Miller ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Tumor Cells ◽  
Small Cell Carcinoma ◽  
Mononuclear Cells ◽  
Checkpoint Inhibitors ◽  
Small Cell ◽  
Formalin Fixed Paraffin ◽  
Programmed Death ◽  
Formalin Fixed Paraffin Embedded ◽  
Formalin Fixed

e16019 Background: Small cell carcinoma of bladder (SCCB) is a rare but aggressive variant of bladder neoplasm. There is limited insight for risk prognostication and treatment guidance in this entity. Immune checkpoint inhibitors (ICI), anti-PD-1 or anti-PD-L1 antibodies, have been approved for treating urothelial carcinoma, while the evidence of their efficacy in SCCB is lacking. PD-L1 expression in tumor tissue of urothelial cancer has been postulated to correlate with response to ICI but with controversy. We have studied the expression of PD-L1 in SCCB and its association with patient survival. Methods: Nineteen cases of SCCB diagnosed between 2011 and 2017 in a single center were identified. Formalin-fixed paraffin-embedded tumor samples were stained for PD-L1 (Ventana PD-L1 SP142). Cases showing positive stain in 5% or more of tumor cells and tumor stromal mononuclear cells (TSMC) were considered positive. Results: Among 19 cases of SCCB, 4 (21%) stained positive for PD-L1. All 4 cases had strong PD-L1 staining ( > 30%) seen in the TSMC but barely in tumor cells (focal < 5% cells in 2/4 cases). Except for one patient who died from surgery, all remaining 3 patients with positive PD-L1 staining are still alive. Twelve out of 19 SCCB patients developed metastatic disease; 4 of them were treated with ICI. The only responder of the 4 patients had strong PD-L1 expression in TSMC cells. The overall survival for patients with positive PD-L1 staining was 41 months versus 14 months for those with negative staining (p = 0.09). Age, pathologic stage and treatments were similar between the two groups. Conclusions: In our study, PD-L1 expression was seen in 21% of tumor samples from patients with SCCB, mostly in TSMC, but minimal in tumor cells. The strong expression of PD-L1 in TSMC correlates with a trend of improved survival and potential response to ICI in SCCB. PD-L1 expression in TSMC, rather than tumor cells, could be used as a marker for prognosis in SCCB.

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