scholarly journals Partial response to erlotinib in a patient with imatinib-refractory sacral chordoma

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Saurav Verma ◽  
Surya Prakash Vadlamani ◽  
Shamim Ahmed Shamim ◽  
Adarsh Barwad ◽  
Sameer Rastogi ◽  
...  
Keyword(s):  
Partial Response ◽  
Therapeutic Option ◽  
Palliative Radiotherapy ◽  
Distant Metastases ◽  
Resistant Disease ◽  
Sacral Chordoma ◽  
Mesenchymal Neoplasm ◽  
Radiological Response ◽  
Localized Disease ◽  
Slow Growing

Abstract Background Chordoma is a rare, slow growing and locally aggressive mesenchymal neoplasm with uncommon distant metastases. It is a chemo-resistant disease with surgery and radiotherapy being the mainstay in treatment of localized disease. In advanced disease imatinib has a role. We report a case of metastatic sacral chordoma with symptomatic and radiological response to erlotinib post-progression on imatinib. Case presentation A 48-year-old male with a sacral chordoma underwent partial sacrectomy followed by post-operative radiotherapy. Upon recurrence he received palliative radiotherapy to hemipelvis and was offered therapy with imatinib. However, the disease was refractory to imatinib and he was started on treatment with erlotinib—showing a partial response on imaging at two months. He is currently doing well at 13 months since start of erlotinib. Conclusions As seen in previously reported cases, erlotinib is a therapeutic option in advanced chordoma, even in imatinib refractory cases and thus warrants exploration of its therapeutic role in prospective clinical trials.

scholarly journals NCOG-19. BEVACIZUMAB IN REAL LIFE PATIENTS WITH RECURRENT GLIOBLASTOMA: BENEFIT OR FUTILITY?

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii133-ii133
Author(s):  
Cristina Smolenschi ◽  
Emeline Colomba ◽  
Elie Rassy ◽  
Naima Lezghed ◽  
Mohamed Kettab ◽  
...  
Keyword(s):  
Clinical Benefit ◽  
Therapeutic Option ◽  
Performance Status ◽  
Objective Response ◽  
Real Life ◽  
Complete Response ◽  
Recurrent Glioblastoma ◽  
Arterial Bleeding ◽  
Substantial Clinical Benefit ◽  
Radiological Response

Abstract Angiogenesis represents a hallmark of glioblastoma but most trials disappointed and failed to change the poor outcome of this disease. However, Bevacizumab (Bev) is widely used in clinical practice by expert oncologists due to experience or efficacy in real life.We retrospectively reviewed the use of Bev and its benefit in terms of Time to treatment failure (TTF), Overall Survival(OS), Objective Response Rate (ORR) and clinical benefit. METHODS: We analyzed two hundred and two patients treated at Gustave Roussy Cancer Campus with Bev until definitive failure for recurrent glioblastoma between 2006 and 2016. Patients were treated with Bev alone or in association with radiotherapy, temozolomide, lomustine or irinotecan. RESULTS: The median duration of Bev treatment until definitive failure was 6 months. The median TTF was 7.27 months(95%CI 6.30-8.24) and the median OS from diagnosis was 22.43 months(95%CI 19.68-25.18). Two patients were still alive without active treatment at the end of study. A hundred and fourteen (56%) patients experienced symptom amelioration and seventy-five (37%) improved their Performance Status. Fifty percent of patients exhibited Partial and Complete Response on MRI, as best radiological response, within 1.6 months. No patient had anaphylactic reaction. Grade 1-2 hypertension(HT)(17%) and grade 1(10%) proteinuria were most common. Six patients presented lethal toxicity: 4 with GI perforation, 1 p with cerebral hemorrhage and 1 p with arterial bleeding. HT was correlated with treatment response in 67% of patients. A neutrophil count superior to 6000/mm³ was associated with longer TTF(mTTF 8.23m(95%CI 6.64-9.82). CONCLUSION: This retrospective study reports a substantial clinical benefit of Bev in patients with recurrent glioblastoma with an acceptable toxicity profile. As the panel of therapeutic option is still very limited in these tumors, this work supports the maintained use of Bev as a therapeutic option.

Bowen’s Disease of the Anal Canal Treated with Radiation Therapy: A Case Report

2021 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
I. Mbarki Mbarki
Keyword(s):  
Anal Canal ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Intraepithelial Neoplasia ◽  
Bowen’S Disease ◽  
Bowen's Disease ◽  
Radiological Response ◽  
Slow Growing

Bowen’s disease, also known as intraepithelial neoplasia, is a very slow-growing carcinoma in situ. It can progress to an invasive squamous cell cancer and infiltrate mucosa or skin in 3 to 5% of cases. The anal localization of this disease is very rare. Surgical resection is the standard of treatment. Radiotherapy keeps its place in recurrent or unresectable cases. We report a case of Bowen’s anal canal disease in order to verify the effectiveness of Radiotherapy. He is a 59-years-old patient diagnosed with Bowen’s anal canal disease at the National Institute of Oncology in Rabat. He was treated with exclusive radiotherapy at a dose of 60 Gray in 30 fractions over 49 days. The evolution was marked by a complete clinical and radiological response and preservation of the anal sphincter with an 18 months follow-up.

scholarly journals In Vitro Activity of Rifamycin Derivatives against Nontuberculous Mycobacteria, Including Macrolide- and Amikacin-Resistant Clinical Isolates

2021 ◽  
Vol 65 (5) ◽  
Author(s):  
Dae Hun Kim ◽  
Su-Young Kim ◽  
Hee Jae Huh ◽  
Nam Yong Lee ◽  
Won-Jung Koh ◽  
...  
Keyword(s):  
Mycobacterium Avium ◽  
Nontuberculous Mycobacteria ◽  
Therapeutic Option ◽  
Vitro Activity ◽  
Clinical Isolates ◽  
Drug Resistant ◽  
In Vitro Activity ◽  
Content Type ◽  
Resistant Disease

ABSTRACT We evaluated the in vitro activity of rifamycin derivatives, including rifampin, rifapentine, rifaximin, and rifabutin, against clinical nontuberculous mycobacteria (NTM) isolates. Of the rifamycin derivatives, rifabutin showed the lowest MICs against all NTM species, including Mycobacterium avium complex, M. abscessus, and M. kansasii. Rifabutin also had effective in vitro activity against macrolide- and aminoglycoside-resistant NTM isolates. Rifabutin could be worth considering as a therapeutic option for NTM disease, particularly drug-resistant disease.

scholarly journals Xp 11.2 translocation renal carcinoma in young adults; recently classified distinct subtype

2014 ◽  
Vol 48 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Andrej Kmetec ◽  
Jera Jeruc
Keyword(s):  
Young Adults ◽  
Case Report ◽  
Young Adult ◽  
Lymph Nodes ◽  
Renal Carcinoma ◽  
Distant Metastases ◽  
Advanced Stage ◽  
Adult Males ◽  
Slow Growing ◽  
Distinct Subtype

Abstract Background. XP11.2 renal translocation carcinomas are often encountered in paediatric group of patients where they are believed to be rather indolent. They are rare but more aggressive in young adults. They are slow growing, sometimes without characteristic symptoms and their biologic behaviour is uncertain. Case report. We report two cases of this type of tumour in Slovenian young adult males with long and unusual history. Tumours were confirmed imunohistologically by positive reaction for CD10, P504S and TFE3. Conclusions. According to the indications in the literature prognosis of these tumours in young adults depends upon the stage. It seems that cysts, haematomas and necrosis around the kidney are often encountered in these tumours. In advanced stage with lymph nodes involvement or distant metastases, the prognosis is poor. Surgery seems to be basic mode of therapy

Colon Cancer

2018 ◽  
Author(s):  
Richard S Hoehn ◽  
Felipe Quezada-Diaz ◽  
Jesse J Smith
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Surgical Resection ◽  
Distant Metastases ◽  
Disease Recurrence ◽  
The United States ◽  
Oncologic Outcomes ◽  
Perioperative Outcomes ◽  
Increased Risk ◽  
Localized Disease

Colon cancer is a leading cause of cancer-related death in the United States and worldwide. Routine screening has led to early diagnosis and improved survival for many patients but is still greatly underused. Complete surgical resection provides the best opportunity for cure of localized disease and requires removal of a defined segment of colon along with its lymphovascular pedicle, including a minimum of 12 lymph nodes. Minimally invasive approaches have been shown to provide better perioperative outcomes and patient recovery, with oncologic outcomes equivalent to those of traditional open surgery. Patients with lymph node metastases are at an increased risk of distant metastases and disease recurrence. Survival for these patients has improved in the recent years with the advent of oxaliplatin-based adjuvant chemotherapy. In addition, surgical resection is increasingly being used to control and sometimes cure distant metastases. In this chapter, we review the current strategies for diagnosing and managing colon cancer.   This review contains 1 video, 5 figures, 4 tables and 48 references Key Words: adjuvant chemotherapy, anastomosis, colectomy, colon cancer, neoadjuvant chemotherapy, surgery, survival, laparoscopic, robotic

scholarly journals Ghost cell odontogenic carcinoma: Role of p53 as predictor of progression

2020 ◽  
Vol 10 (1) ◽  
pp. 1675-1678
Author(s):  
Pallavi Srivastava ◽  
Nidhi Anand ◽  
Nuzhat Husain
Keyword(s):  
Distant Metastases ◽  
Proliferation Index ◽  
Ghost Cell ◽  
Ki 67 ◽  
Local Recurrences ◽  
Odontogenic Carcinoma ◽  
Fibular Flap ◽  
Slow Growing

Ghost cell odontogenic carcinoma (GCOC) a rare malignant Odontogenic Carcinoma with an unpredictable behaviour presenting with local recurrences and distant metastases, to best of our knowledge about 38 cases have been reported in the past. This is an additional case of GCOC in a 25-year old female presented with a slow-growing mandibular swelling since 9 months with restricted jaw mobility. The CT scan showed an ill-defined osteodestructive lesion in the mandible. The histological examination confirms the diagnoses as a GCOC. Immunohistochemical examination was performed for Ki-67 proliferation index and p53 a predictor of progression. This case was managed by wide surgical resection of tumor and reconstruction of the defect by free fibular flap. Six months follow- up period shows no signs of recurrence. GCOC is rare Odontogenic Carcinoma with unpredictable behaviour however p53 & Ki67 proliferation index can predict the progression of tumor and help in differentiation from benign precursor lesions as early diagnosis & treatment of GCOC is necessary to prevent local recurrences & distant metastases.

Measuring response to neoadjuvant chemotherapy in high-grade serous tubo-ovarian carcinoma: an analysis of the correlation between CT imaging and chemotherapy response score

2019 ◽  
Vol 29 (5) ◽  
pp. 929-934 ◽  
Author(s):  
Meabh McNulty ◽  
Adarsh Das ◽  
Paul A Cohen ◽  
Andrew Dean
Keyword(s):  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Partial Response ◽  
Stable Disease ◽  
Progression Free Survival ◽  
Chemotherapy Response ◽  
High Grade ◽  
Free Survival ◽  
Radiological Response ◽  
Response Score

IntroductionResponse to neoadjuvant chemotherapy is measured by CT and the decision to proceed with interval surgery is made on the radiological response after two or three cycles of therapy. The Chemotherapy Response Score grades histological tumor regression in omental metastases resected at interval surgery and is associated with progression-free survival and overall survival. It is uncertain whether radiological response is associated with prognosis and whether radiological response predicts Chemotherapy Response Score.To assess if radiological response is associated with progression-free survival and overall survival. Additionally, to investigate whether radiological response predicts the Chemotherapy Response Score.MethodsRetrospective cohort study of patients with high-grade serous ovarian cancer treated with neoadjuvant chemotherapy. Radiological response was assessed by comparing CT imaging at baseline and after neoadjuvant chemotherapy using RECIST (Response Evaluation Criteria In Solid Tumors) and classified as stable disease, partial response, complete response, or progressive disease. Survival analysis was performed using Cox proportional-hazard models and the log-rank test.ResultsA total of 71 patients met the inclusion criteria. Of these, 51 had pre- and post-neoadjuvant chemotherapy CT scans available for analysis. Radiological response was not associated with progression-free survival or overall survival on univariate analysis (stable disease vs partial response; HR for progression-free survival 1.15; 95% CI 0.57 to 2.32; p = 0.690; HR for overall survival 1.19; 95% CI 0.57 to 2.46; p = 0.645). In a multivariate model, radiological response was not associated with either progression-free survival (stable disease vs partial response; HR=1.19; 95% CI 0.498 to 2.85; p = 0.694) or overall survival (stable disease vs partial response; HR=0.954; 95% CI 0.38 to 2.40; p = 0.920). There was a significant association between the Chemotherapy Response Score and radiological response (p = 0.005).DiscussionA partial response and stable disease on radiological assessment after neoadjuvant chemotherapy in women with advanced high-grade serous ovarian cancer were not associated with survival, despite having a correlation with the Chemotherapy Response Score.

scholarly journals Solitary extrapleural fibrous tumor with hepatic bilobar metastases: multimodal approach treatment

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Maitane I. Orue-Echebarria ◽  
Laura Garciafília ◽  
Luis Rodriguez-Bachiller ◽  
Benjamín Díaz-Zorita ◽  
Enrique Velasco ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Solitary Fibrous Tumor ◽  
Future Liver Remnant ◽  
Distant Metastases ◽  
R0 Resection ◽  
Two Stage ◽  
Liver Remnant ◽  
Therapeutic Decisions ◽  
Mesenchymal Neoplasm ◽  
Fibrous Tumor

Abstract Background Solitary fibrous tumor is an unusual fibroblastic mesenchymal neoplasm typically described in the pleura. It may appear anywhere with a varied anatomic distribution and essentially it can develop from any soft tissue or visceral location. Its course is usually indolent and it rarely causes distant metastases, so it has a prolonged survival rate. It sometimes presents itself as a disseminate disease being the liver the most frequently involved location. In these occasions, the management should be discussed in a multidisciplinary tumor committee formed by surgeons, oncologists and radiologists. Surgery remains the gold standard for treatment. Case representation We present the case of a woman with a tumor in the left abdominal wall and bilobar massive liver metastases, both locations histologically diagnosed as solitary fibrous tumor. She receives biological treatment for a severe case of Crohn´s disease. Evaluated in a multidisciplinary committee, surgery was recommended for both the primary lesion and the liver metastases. The hepatobiliary surgeons considered a two-stage hepatectomy with portal vein embolization (PVE) as the best strategy. After the first procedure consisting in cleaning the left hepatic lobe followed by PVE the future liver remnant volume (FLRV) was considered inadequate, so the patient was also treated with right transarterial radioembolizacion with yttrium 90 (TARE-Y90) intending a double goal: to treat the tumor and to increased the FLRV. Furthermore, a severe flare of Crohn´s disease forced us to intensify the patient’s treatment with the addition of biological agents (infliximab and adalimumab) until complete remission of the symptoms. The second stage of the liver surgery had to be postponed for more than 6 months and could finally be carried out without complications, achieving an R0 resection. The postoperative course was uneventful and the follow up has showed no recurrence to date. Conclusion Solitary fibrous tumours with extensive liver metastases are infrequent but when they appear modern surgical strategies like two stage hepatectomy are the treatment of choice and must be carried out by specialised units. The therapeutic decisions should be guided by a multidisciplinary committee.

scholarly journals The radiation therapy options of intracranial hemangiopericytoma: An overview and update on a rare vascular mesenchymal tumor

2018 ◽  
Author(s):  
Maria Paola Ciliberti ◽  
Rosa D'Agostino ◽  
Laura Gabrieli ◽  
Anna Nikolaou ◽  
Angela Sardaro
Keyword(s):  
Surgical Resection ◽  
Adjuvant Radiotherapy ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Distant Metastases ◽  
Complete Resection ◽  
Complete Surgical Resection ◽  
Hypervascular Tumor ◽  
The Central Nervous System ◽  
Radiotherapy Treatment

Hemangiopericytoma (HPC) is an extremely rare hypervascular tumor of mesenchymal lineage. It tends to recur and to develop distant metastases even many years after primary surgical resection. The management of recurrent and metastatic disease is not always so well defined. A complete surgical resection does not eliminate the high risk of local recurrences that occur in the central nervous system, often in the same surgical bed. However, treatment with adjuvant radiotherapy even in cases of complete resection remains controversial. Because of its rarity, there is no standard for treatment. We focused on radiotherapy treatment options, analyzing the literature and making a base on conduct further studies to establish the standard radiation dose to be used for locoregional control of such a complex and extremely rare disease and to help specialists to take the most appropriate therapeutic option.

Does Surgery Improve the Survival of Patients with Advanced Anaplastic Thyroid Carcinoma?

1998 ◽  
Vol 118 (5) ◽  
pp. 728-731
Author(s):  
WEN-TSOUNG LU ◽  
Jen-Der Lin ◽  
Hong-So Huang ◽  
Tzu-Chieh Chao
Keyword(s):  
Thyroid Carcinoma ◽  
Distant Metastases ◽  
Anaplastic Thyroid Carcinoma ◽  
Disease Group ◽  
Localized Disease ◽  
The Mean ◽  
Group 2 ◽  
Nonsurgical Patients ◽  
Head Neck ◽  
Group 1

Anaplastic thyroid carcinoma is one of the most lethal neoplasms, with poor prognosis being reported by most authors. The benefits of surgery for most cases of advanced disease remain controversial. In this study we asked the following question: Does surgical intervention alter outcomes for patients with advanced anaplastic thyroid carcinoma? Forty-six patients with advanced anaplastic thyroid carcinoma were analyzed. There were 20 patients with advanced localized disease (group 1), 15 of whom received surgery. Of the other 26 patients with evidence of distant metastases (group 2), 13 received surgery. For group 1 patients, the mean survival was 12.8 months versus 8.6 months in the surgical and nonsurgical subgroups ( p = 0.46). For group 2 patients, the mean survival was 3.5 months versus 2.8 months in the surgical and nonsurgical subgroups ( p = 0.72). These data suggest that surgery does not improve survival for patients with advanced anaplastic thyroid carcinoma. In conclusion, the mean survival showed no significant differences between surgical and nonsurgical patients ( p = 0.43). This study suggests that surgical resection does not improve the survival of patients with advanced anaplastic thyroid carcinoma. (Otolaryngol Head Neck Surg 1998;118:728–31.)

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