scholarly journals Successful afatinib treatment through nasogastric tube in a ventilated patient with non-small cell lung cancer

2017 ◽  
Vol 3 (4) ◽  
Author(s):  
Takahiro Karasuno ◽  
Nobuko Nishiura ◽  
Hiroyuki Takamori ◽  
Ken Kodama
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Nasogastric Tube ◽  
Kinase Inhibitors ◽  
Egfr Mutation ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
Life Threatening

<p class="BodyText1">The majority of lung cancer patients are discovered at advanced stages and some of them may often have complex medical problems in addition to the diagnosis of cancer, such as oncologic emergency requiring assistance in an intensive care unit (ICU). In the last decade, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors have been recognized as key drugs for non-small cell lung cancer (NSCLC) harboring sensitive EGFR mutation. We report a case of stage IV NSCLC with EGFR mutation (exon 19 deletion). He was in a life-threatening stage due to a massive intrathoracic hemorrhage. After chest tube drainage and mechanical ventilation, afatinib was administered through nasogastric tube. Consequently, a dramatic response was obtained and he was able to be discharged from our hospital 11 weeks after the initiation of afatinib. This approach may be of benefit to rescue from life-threatening condition for selected patients.</p>

scholarly journals Real-world osimertinib for EGFR mutation-positive non-small-cell lung cancer with acquired T790M mutation

2020 ◽  
Vol 16 (21) ◽  
pp. 1537-1547
Author(s):  
Fumio Imamura ◽  
Madoka Kimura ◽  
Yukihiro Yano ◽  
Masahide Mori ◽  
Hidekazu Suzuki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Kinase Inhibitors ◽  
Egfr Mutation ◽  
Acquired Resistance ◽  
Small Cell ◽  
Small Cell Lung ◽  
T790m Mutation ◽  
Clinical Trial Registration

Aim: Osimertinib is a key drug for EGFR mutation-positive non-small-cell lung cancer (NSCLC). As the hazards ratio of overall survival in comparison with first-generation EGFR-tyrosine kinase inhibitors was almost similar between FLAURA and ARCHER 1050, salvage use of osimertinib is still a treatment option. Patients & methods: We retrospectively analyzed the clinical courses of EGFR mutation-positive NSCLC patients who were potential candidates for salvage osimertinib. Results: Among 524 patients enrolled from five hospitals, 302 patients underwent biopsy, with 52.6% detection rate of T790M. Osimertinib was administered in 93.6% of the T790M-positive patients. The overall response rate and median progression-free survival time of osimertinib were calculated with 147 patients, to be 55.6% and 17.2 months, respectively. Conclusion: Osimertinib is active for T790M-driven acquired resistance in EGFR-mutant NSCLC, but the detection of T790M was unsatisfactory. Clinical Trial Registration: UMIN000028989 (UMIN Clinical Trials Registry)

scholarly journals Network meta-analyses for EGFR mutation-positive non-small-cell lung cancer: systematic review and overview of methods and shortcomings

2020 ◽  
Vol 9 (17) ◽  
pp. 1179-1194
Author(s):  
Carl Samuelsen ◽  
Ingolf Griebsch
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Kinase Inhibitors ◽  
Egfr Mutation ◽  
Small Cell ◽  
Future Research ◽  
Small Cell Lung ◽  
Meta Analyses

Aim: To perform a review of network meta-analyses (NMAs) for the first-line treatment of EGFR mutation-positive non-small-cell lung cancer, and to provide an overview of methodological approaches and potential shortcomings. Materials & methods: We conducted a systematic review of NMAs and evaluated their methodologies, including inclusion/exclusion criteria, information sources, results and outcomes, and statistical methodologies. Results: We identified ten published NMAs using five archetypical network structures. Despite similar objectives, there was substantial variability in the number of trials included in each NMA and in the relative treatment efficacy of the tyrosine kinase inhibitors. Conclusion: We identified methodological issues to explain differences in the findings, criteria for inclusion in NMAs and the degree of lumping of treatments. These factors should be given particular consideration in future research.

scholarly journals Pneumothorax during Pemetrexed Treatment in a Patient with Non-Small Cell Lung Cancer: A Case Report and Literature Review

2017 ◽  
Vol 10 (2) ◽  
pp. 428-432 ◽  
Author(s):  
Yoshiro Nakahara ◽  
Shinichiro Mikura ◽  
Makoto Nagamata ◽  
Tomoya Fukui ◽  
Jiichiro Sasaki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Stage Iv ◽  
Additional Treatment ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Case ◽  
Life Threatening ◽  
Third Line

Pemetrexed is a multitargeted antifolate that has demonstrated antitumor activity in non-small cell lung cancer. A 70-year-old male presented with a stage IV non-small cell lung cancer. The patient was treated with pemetrexed as third-line chemotherapy. However, a pneumothorax occurred 16 days after the administration of the second cycle of pemetrexed. The pneumothorax was slight and the patient was observed without undergoing any additional treatment. Twenty-four days after its initial occurrence, the pneumothorax had improved. This is the first case of pneumothorax that has been observed during pemetrexed treatment. Pneumothorax during chemotherapy is rare; however, it is a life-threatening complication and should not be overlooked.

scholarly journals Characteristics and outcomes of RET-rearranged Korean non-small cell lung cancer patients in real-world practice

2020 ◽  
Vol 50 (5) ◽  
pp. 594-601 ◽  
Author(s):  
Jiyun Lee ◽  
Bo Mi Ku ◽  
Joon Ho Shim ◽  
Yoon La Choi ◽  
Jong-Mu Sun ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Kinase Inhibitors ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival ◽  
Intracranial Metastases

Abstract Objective Since the first discovery of rearranged during transfection (RET) fusion in lung adenocarcinoma in 2011, two tyrosine kinase inhibitors, namely vandetanib and cabozantinib, are currently available. Despite favorable outcomes in systemic control, the intracranial therapeutic response remains insufficient. In this study, the clinical characteristics and outcomes of non-small cell lung cancer (NSCLC) patients with RET rearrangements were analyzed. Methods Patients with NSCLC harboring RET fusion who received treatment between January 2006 and January 2018 were analyzed. RET rearrangement was identified by FISH or NGS. Results A total of 59 patients were identified. About half of the patients were female (47.5%) and never smokers (50.9%). Most patients had adenocarcinoma (89.8%). A total of 17 patients (28.8%) had an intracranial lesion at the initial diagnosis of stage IV disease, and 11 additional patients (18.6%) developed intracranial metastases during follow-up. The median time to development of intracranial metastases was 19.0 months (95% CI: 9.6–28.5), resulting in a &gt;60% cumulative incidence of brain metastasis at 24 months. The systemic efficacy of pemetrexed-based regimens was favorable with progression-free survival of 9.0 (95% CI: 6.9–11.2) and OS of 24.1 (95% CI: 15.2–33.0) months. The median progression-free survival for vandetanib and immunotherapy was 2.9 (95% CI: 2.0–3.8) and 2.1 (95% CI: 1.6–2.6) months, respectively. Conclusions Given the likelihood of RET-rearranged NSCLC progressing to intracranial metastases and the absence of apparent clinical benefit of currently available targeted or immunotherapeutic agents, development of novel treatment with higher selectivity and better penetration of the blood–brain barrier remains a priority.

scholarly journals EGFR Mutation Positive Stage IV Non-Small-Cell Lung Cancer: Treatment Beyond Progression

2014 ◽  
Vol 4 ◽  
Author(s):  
Katrijn Van Assche ◽  
Liesbeth Ferdinande ◽  
Yolande Lievens ◽  
Katrien Vandecasteele ◽  
Veerle Surmont
Keyword(s):  
Lung Cancer ◽  
Cancer Treatment ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Egfr Mutation ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancer Treatment ◽  
Treatment Beyond Progression

Depression and EGFR mutation status in stage IV non-small cell lung cancer.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. 9086-9086
Author(s):  
W. F. Pirl ◽  
J. Greer ◽  
H. Bemis ◽  
R. S. Heist ◽  
E. Gallagher ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Egfr Mutation ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
Mutation Status

scholarly journals Biopsy on progression in patients with EGFR mutation–positive advanced non-small-cell lung cancer—a Canadian experience

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Q. Chu ◽  
A. Agha ◽  
N. Devost ◽  
R. N. Walton ◽  
S. Ghosh ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Kinase Inhibitors ◽  
Egfr Mutation ◽  
Mutational Analysis ◽  
Small Cell ◽  
Small Cell Lung ◽  
T790m Mutation ◽  
Platinum Based Chemotherapy

Background Epidermal growth factor receptor (egfr) tyrosine kinase inhibitors (tkis) are standard therapy for patients with advanced or metastatic non-small-cell lung cancer harbouring an EGFR mutation. Upon progression, 50%–60% develop a secondary T790M mutation. Recent trials demonstrated outcome improvement with osimertinib compared with standard platinum-based chemotherapy as second-line therapy for patients with secondary T790M mutation. To identify T790M, a biopsy of the tumour or, more recently, plasma is necessary. This retrospective study aimed to evaluate biopsy procedures and mutational analysis at 2 Canadian cancer centres.Methods In a retrospective review of patients who were approached to enrol in the aura2, aura3, or astris studies, demographics, eligibility for rebiopsy upon progression after an egfr tki, rebiopsy methods and complications, number of rebiopsies, and incidence of the T790M mutation were collected.Results Of 84 patients considered for trial enrolment, 80 signed a consent. In 78 patients who underwent rebiopsy, computed tomography or ultrasonography guidance were the most common methods used. The most common biopsy sites were lung and lymph nodes. The median number of rebiopsies performed to find a T790M mutation was 2. Only 9% of patients experienced complications. Of samples obtained, 74% were adequate for testing after initial rebiopsy. A T790M mutation was found in 47 patients, of whom 44 were enrolled on a trial. After multiple rebiopsies, only 5% of samples were inadequate for molecular analysis.Conclusions In the Canadian setting, the acceptance of rebiopsy on progression was high. Multiple rebiopsies were clinically feasible and could increase the yield for T790M mutation. The incidence of complications was low despite the most common site for rebiopsy being lung.

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