المؤلفون: Kitadai R; Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Japan., Zenke Y; Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan., Hishima T; Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Japan., Hosomi Y; Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Japan.

المصدر: Cancer reports (Hoboken, N.J.) [Cancer Rep (Hoboken)] 2022 Feb; Vol. 5 (2), pp. e1460. Date of Electronic Publication: 2021 May 27.

نوع المنشور: Case Reports; Journal Article

بيانات الدورية: Publisher: John Wiley & Sons, Inc Country of Publication: United States NLM ID: 101747728 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2573-8348 (Electronic) Linking ISSN: 25738348 NLM ISO Abbreviation: Cancer Rep (Hoboken) Subsets: MEDLINE

مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*therapeutic use , Brain Neoplasms/*drug therapy , Brain Neoplasms/*secondary , Carcinoma, Non-Small-Cell Lung/*pathology , Lung Neoplasms/*pathology , Nivolumab/*administration & dosage, Aged ; Brain Neoplasms/diagnostic imaging ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Female ; Humans ; Lung Neoplasms/drug therapy ; Magnetic Resonance Imaging ; Neoplasm Staging

مستخلص: Background: Nivolumab has shown promising results against non-small-cell lung cancer (NSCLC). However, its efficacy to treat central nervous system (CNS) metastases, specifically among programmed cell death 1 ligand 1 (PD-L1)-negative patients, remains unclear.
Case: A 66-year-old woman was diagnosed with adenocarcinoma stage II and underwent a left lower lobectomy. The histopathological evaluation revealed stage IVA with pleural dissemination. The patient did not harbor an epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) rearrangement, and PD-L1 expression of the surgical specimen using 22C3 assay was 0%. Single brain metastasis was detected, and carboplatin and nab-paclitaxel were administered. After three cycles, asymptomatic multiple brain metastases were identified, and the patient was treated with nivolumab as second-line chemotherapy. Six months later, MRI revealed an intracranial complete response (CR). Nivolumab was discontinued after 23 cycles due to immune-related adverse events (irAEs) of grade 2 rash. However, its effects were sustained for 13 months after discontinuation. We were unable to evaluate the PD-L1 expression of brain metastases, which may show heterogeneity.
Conclusion: This case demonstrates that nivolumab effectively treated a patient with negative PD-L1 expression of the lung harboring CNS metastases.
(© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.)

المؤلفون: Gadde R; 2971Henry Ford Health System, Henry Ford Hospital, Detroit, MI, USA.; These authors contributed equally to the study., Arora K; 2971Henry Ford Health System, Henry Ford Hospital, Detroit, MI, USA.; These authors contributed equally to the study., Felicella MM; 115467Barrow Neurological Institute, Phoenix, AZ, USA., Arora S; Indiana University, Indianapolis, IN, USA., Cheng L; Indiana University, Indianapolis, IN, USA., Park H; 2971Henry Ford Health System, Henry Ford Hospital, Detroit, MI, USA., Gupta NS; 2971Henry Ford Health System, Henry Ford Hospital, Detroit, MI, USA., Salamat MS; 5229University of Wisconsin, Madison, WI, USA., Williamson SR; 2971Henry Ford Health System, Henry Ford Hospital, Detroit, MI, USA.; Wayne State University, Detroit, MI, USA.

المصدر: International journal of surgical pathology [Int J Surg Pathol] 2020 Dec; Vol. 28 (8), pp. 925-928. Date of Electronic Publication: 2020 Jun 04.

نوع المنشور: Case Reports; Journal Article

بيانات الدورية: Publisher: Sage Publications Country of Publication: United States NLM ID: 9314927 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1940-2465 (Electronic) Linking ISSN: 10668969 NLM ISO Abbreviation: Int J Surg Pathol Subsets: MEDLINE

مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*administration & dosage , Brain Neoplasms/*therapy , Frontal Lobe/*pathology , Neoplasms, Germ Cell and Embryonal/*therapy , Trophoblastic Neoplasms/*diagnosis, Brain Neoplasms/blood ; Brain Neoplasms/diagnosis ; Brain Neoplasms/pathology ; Chemoradiotherapy, Adjuvant/methods ; Child ; Chorionic Gonadotropin, beta Subunit, Human/blood ; Chromosomes, Human, Pair 12/genetics ; Female ; Frontal Lobe/diagnostic imaging ; Frontal Lobe/drug effects ; Frontal Lobe/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Neoadjuvant Therapy ; Neoplasms, Germ Cell and Embryonal/blood ; Neoplasms, Germ Cell and Embryonal/diagnosis ; Neoplasms, Germ Cell and Embryonal/secondary ; Neurosurgical Procedures ; Proton Therapy ; Trophoblastic Neoplasms/secondary ; alpha-Fetoproteins/analysis

مستخلص: Cystic trophoblastic tumor (CTT) is an uncommon trophoblastic proliferation of germ cell tumor origin, mostly reported in post-chemotherapy metastases of testicular germ cell tumors and rarely primary untreated testicular tumors. To date, we are not aware of occurrence in a non-testicular tumor. A 12-year-old boy presented with limb swelling, increased appetite, weight gain, and precocious puberty. Evaluation revealed right frontal lobe mass and elevated α-fetoprotein and β-human chorionic gonadotrophin. After response to neoadjuvant chemotherapy, the tumor was resected. Microscopically, the resection contained predominantly smooth muscle tissue with scattered small foci of glandular teratoma and CTT. Immunohistochemistry (SALL4, glypican 3) revealed no residual yolk sac tumor. Fluorescence in situ hybridization revealed gain of chromosome 12p. The patient has been disease-free for 13 years. This report expands the spectrum of primary central nervous system germ cell tumors with the occurrence of CTT in this site.

المؤلفون: Tosi F; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy., Sartore-Bianchi A; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy., Lonardi S; Oncologia Medica 1, Istituto Oncologico Veneto - IRCCS, Padova, Italy., Amatu A; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Leone F; Department of Oncology, ASL BI, Ospedale degli Infermi, Biella, Italy; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia-IRCCS, Candiolo, Italy., Ghezzi S; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Martino C; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia-IRCCS, Candiolo, Italy., Bencardino K; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Bonazzina E; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Bergamo F; Oncologia Medica 1, Istituto Oncologico Veneto - IRCCS, Padova, Italy., Fenocchio E; Multidisciplinary Outpatient Oncology Clinic, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy., Martinelli E; Università della Campania 'L. Vanvitelli', Naples, Italy., Troiani T; Università della Campania 'L. Vanvitelli', Naples, Italy., Siravegna G; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia-IRCCS, Candiolo, Italy; Dipartimento di Oncologia, Università degli Studi di Torino, Turin, Italy., Mauri G; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy., Torri V; Dipartimento di Oncologia, Istituto Mario Negri - IRCCS, Milan, Italy., Marrapese G; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Valtorta E; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Cassingena A; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Cappello G; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia-IRCCS, Candiolo, Italy., Bonoldi E; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Vanzulli A; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Regge D; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia-IRCCS, Candiolo, Italy., Ciardiello F; Università della Campania 'L. Vanvitelli', Naples, Italy., Zagonel V; Oncologia Medica 1, Istituto Oncologico Veneto - IRCCS, Padova, Italy., Bardelli A; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia-IRCCS, Candiolo, Italy; Dipartimento di Oncologia, Università degli Studi di Torino, Turin, Italy., Trusolino L; Istituto di Candiolo, Fondazione del Piemonte per l'Oncologia-IRCCS, Candiolo, Italy; Dipartimento di Oncologia, Università degli Studi di Torino, Turin, Italy., Marsoni S; Precision Oncology, IFOM-FIRC Institute of Molecular Oncology, Milan, Italy., Siena S; Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Milan, Italy. Electronic address: salvatore.siena@unimi.it.

المصدر: Clinical colorectal cancer [Clin Colorectal Cancer] 2020 Dec; Vol. 19 (4), pp. 256-262.e2. Date of Electronic Publication: 2020 Jun 27.

نوع المنشور: Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101120693 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-0674 (Electronic) Linking ISSN: 15330028 NLM ISO Abbreviation: Clin Colorectal Cancer Subsets: MEDLINE

مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*administration & dosage , Brain Neoplasms/*drug therapy , Colorectal Neoplasms/*drug therapy , Lapatinib/*administration & dosage , Trastuzumab/*administration & dosage, Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Humanized/administration & dosage ; Antibodies, Monoclonal, Humanized/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Biomarkers, Tumor/analysis ; Biomarkers, Tumor/genetics ; Biomarkers, Tumor/metabolism ; Brain/diagnostic imaging ; Brain/pathology ; Brain Neoplasms/diagnosis ; Brain Neoplasms/mortality ; Brain Neoplasms/secondary ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lapatinib/adverse effects ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Progression-Free Survival ; Proto-Oncogene Proteins p21(ras)/genetics ; Receptor, ErbB-2/analysis ; Receptor, ErbB-2/metabolism ; Trastuzumab/adverse effects

مستخلص: Background: ERBB2 amplification occurs in 5% of RAS wild-type metastatic colorectal cancer (mCRC) and it has been shown to be a target for treatment with 2 HER2-directed combinations of trastuzumab and lapatinib or trastuzumab and pertuzumab. We present long-term clinical results of trastuzumab and lapatinib (HERACLES-A trial) at 6.7 years (82 months) follow-up and focus on central nervous system (CNS) recurrences.
Patients and Methods: Patients had histologically confirmed KRAS exon 2 (codons 12 and 13) wild-type and HER2-positive mCRC. HER2 positivity was assessed by immunohistochemistry and in situ hybridization HERACLES diagnostic criteria. Patients were treated with intravenous trastuzumab 4 mg/kg loading dose, then 2 mg/kg once per week, and oral lapatinib 1000 mg per day until disease progression or toxicity. Patients who presented with symptoms or signs of CNS disease received brain computed tomography scan or magnetic resonance imaging.
Results: A total of 35 patients received trastuzumab and lapatinib and 32 were evaluable for response. One patient (3%) achieved complete response (CR), 8 (25%) partial response, and 13 (41%) stable disease. Therefore, response rate was 28%. Median progression-free survival was 4.7 months (95% confidence interval [CI] 3.7-6.1). Median overall survival was 10.0 months (95% CI 7.9-15.8). One patient achieved sustained CR still maintained at 7 years of follow-up. Progression in the central nervous system (CNS) occurred in 6 (19%) of 32 patients.
Conclusions: Long-term (6.7 years) follow-up analysis of HERACLES-A supports using of trastuzumab and lapatinib as treatment reference for KRAS wild-type, chemorefractory HER2-positive mCRC. In this subset of patients, prolongation of survival is accompanied by CNS recurrences that will require diagnostic and therapeutic attention in future studies. Clinicaltrials. Gov identifier: NCT 03225937.
(Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)

المؤلفون: Leone JP; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Emblem KE; Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway., Weitz M; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Gelman RS; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Schneider BP; Indiana University School of Medicine, Indianapolis, IN, USA., Freedman RA; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Younger J; Massachusetts General Hospital, Boston, MA, USA., Pinho MC; University of Texas Southwestern Medical Center, Dallas, TX, USA., Sorensen AG; IMRIS Inc., Minnetonka, MN, USA., Gerstner ER; Massachusetts General Hospital, Boston, MA, USA., Harris G; Massachusetts General Hospital, Boston, MA, USA., Krop IE; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Morganstern D; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Sohl J; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Hu J; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Kasparian E; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Winer EP; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA., Lin NU; Dana-Farber Cancer Institute, Dana-Farber/Brigham & Women's Cancer Center, 450 Brookline Avenue, Boston, MA, 02215, USA. nlin@partners.org.

المصدر: Breast cancer research : BCR [Breast Cancer Res] 2020 Nov 30; Vol. 22 (1), pp. 131. Date of Electronic Publication: 2020 Nov 30.

نوع المنشور: Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 100927353 Publication Model: Electronic Cited Medium: Internet ISSN: 1465-542X (Electronic) Linking ISSN: 14655411 NLM ISO Abbreviation: Breast Cancer Res Subsets: MEDLINE

مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*administration & dosage , Bevacizumab/*administration & dosage , Brain Neoplasms/*drug therapy , Breast Neoplasms/*drug therapy , Carboplatin/*administration & dosage, Adult ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Bevacizumab/adverse effects ; Brain/diagnostic imaging ; Brain/pathology ; Brain Neoplasms/genetics ; Brain Neoplasms/mortality ; Brain Neoplasms/secondary ; Breast/pathology ; Breast Neoplasms/genetics ; Breast Neoplasms/mortality ; Breast Neoplasms/pathology ; Carboplatin/adverse effects ; Female ; Genotyping Techniques ; Humans ; Kaplan-Meier Estimate ; Magnetic Resonance Imaging ; Middle Aged ; Polymorphism, Single Nucleotide ; Progression-Free Survival ; Trastuzumab/administration & dosage ; Trastuzumab/adverse effects ; Vascular Endothelial Growth Factor A/genetics

مستخلص: Background: We aimed to examine the safety and efficacy of bevacizumab and carboplatin in patients with breast cancer brain metastases.
Methods: We enrolled patients with breast cancer and > 1 measurable new or progressive brain metastasis. Patients received bevacizumab 15 mg/kg intravenously (IV) on cycle 1 day 1 and carboplatin IV AUC = 5 on cycle 1 day 8. Patients with HER2-positive disease also received trastuzumab. In subsequent cycles, all drugs were administered on day 1 of each cycle. Contrast-enhanced brain MRI was performed at baseline, 24-96 h after the first bevacizumab dose (day + 1), and every 2 cycles. The primary endpoint was objective response rate in the central nervous system (CNS ORR) by composite criteria. Associations between germline VEGF single nucleotide polymorphisms (rs699947, rs2019063, rs1570360, rs833061) and progression-free survival (PFS) and overall survival (OS) were explored, as were associations between early (day + 1) MRI changes and outcomes.
Results: Thirty-eight patients were enrolled (29 HER2-positive, 9 HER2-negative); all were evaluable for response. The CNS ORR was 63% (95% CI, 46-78). Median PFS was 5.62 months and median OS was 14.10 months. As compared with an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0, patients with ECOG PS 1-2 had significantly worse PFS and OS (all P < 0.01). No significant associations between VEGF genotypes or early MRI changes and clinical outcomes were observed.
Conclusions: The combination of bevacizumab and carboplatin results in a high rate of durable objective response in patients with brain metastases from breast cancer. This regimen warrants further investigation.
Trial Registration: NCT01004172 . Registered 28 October 2009.

المؤلفون: Li B; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.; Beijing Neurosurgical Institute, Capital Medical University, Beijing, China., Lv W; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Li C; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Yang J; Department of Clinical Nutrition, Beijing Children's Hospital, Capital Medical University, Beijing, China., Chen J; Centre of Endocrinology Genetics and Metabolism, National Centre for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China., Feng J; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Chen L; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Ma Z; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Li Y; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Wang J; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Liu Y; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Li Y; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Liu S; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Luo S; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China., Qiu X; Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.; Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.

المصدر: Cancer research and treatment [Cancer Res Treat] 2020 Oct; Vol. 52 (4), pp. 1050-1058. Date of Electronic Publication: 2020 Jul 09.

نوع المنشور: Comparative Study; Journal Article

بيانات الدورية: Publisher: The Association Country of Publication: Korea (South) NLM ID: 101155137 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2005-9256 (Electronic) Linking ISSN: 15982998 NLM ISO Abbreviation: Cancer Res Treat Subsets: MEDLINE

مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*administration & dosage , Brain Neoplasms/*therapy , Cranial Irradiation/*adverse effects , Craniospinal Irradiation/*adverse effects , Germinoma/*therapy , Neoplasm Recurrence, Local/*epidemiology, Adolescent ; Adult ; Brain Neoplasms/diagnosis ; Brain Neoplasms/mortality ; Chemoradiotherapy/methods ; Child ; Child, Preschool ; Cranial Irradiation/methods ; Craniospinal Irradiation/methods ; Disease-Free Survival ; Female ; Follow-Up Studies ; Germinoma/mortality ; Germinoma/pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/prevention & control ; Pineal Gland/diagnostic imaging ; Pineal Gland/radiation effects ; Quality of Life ; Radiotherapy Dosage ; Young Adult

مستخلص: Purpose: Whether craniospinal irradiation (CSI) could be replaced by limited-field radiation in non-metastatic bifocal germinoma remains controversial. We addressed the issue based on the data from our series and the literature.
Materials and Methods: Data from 49 patients diagnosed with non-metastatic bifocal germinoma at our hospital during the last 10 years were collected. The Pediatric Quality of Life Inventory 4.0 was used to evaluate health-related quality of life (HRQOL). Additionally, 81 patients identified from the literature were also analyzed independently.
Results: In our cohort, 34 patients had tumors in the sellar/suprasellar (S/SS) plus pineal gland (PG) regions and 15 in the S/SS plus basal ganglia/thalamus (BG/T) regions. The median follow-up period was 52 months (range, 10 to 134 months). Our survival analysis showed that patients treated with CSI (n=12) or whole-brain radiotherapy (WBRT; n=34) had comparable disease-free survival (DFS; p=0.540), but better DFS than those treated with focal radiotherapy (FR; n=3, p=0.016). All 81 patients from the literature had tumors in the S/SS+PG regions. Relapses were documented in 4/45 patients treated with FR, 2/17 treated with whole-ventricle irradiation, 0/4 treated with WBRT, and 1/15 treated with CSI. Survival analysis did not reveal DFS differences between the types of radiation field (p=0.785). HRQOL analysis (n=44) in our cohort found that, compared with S/SS+PG germinoma, patients with BG/T involvement had significantly lower scores in social and school domains. However, HRQOL difference between patients treated with CSI and those not treated with CSI was not significant.
Conclusion: In patients with non-metastatic bifocal germinoma, it is rational that CSI could be replaced by limited-field radiation. HRQOL in patients with BG/T involvement was poorer.

المؤلفون: Helal A; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: Helal.ahmed@Mayo.edu., Graffeo CS; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Perry A; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Cheville JC; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Link MJ; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Pollock BE; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

المصدر: World neurosurgery [World Neurosurg] 2020 Jul; Vol. 139, pp. 12-19. Date of Electronic Publication: 2020 Apr 03.

نوع المنشور: Case Reports

بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE

مواضيع طبية MeSH: Metastasectomy* , Radiosurgery*, Antineoplastic Combined Chemotherapy Protocols/*therapeutic use , Brain Neoplasms/*therapy , Lung Neoplasms/*therapy , Sarcoma/*therapy , Soft Tissue Neoplasms/*surgery , Toes/*surgery, Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/genetics ; Brain Neoplasms/secondary ; Female ; Femoral Neoplasms/diagnostic imaging ; Femoral Neoplasms/genetics ; Femoral Neoplasms/secondary ; Femoral Neoplasms/therapy ; Gene Rearrangement ; Humans ; Lung Neoplasms/genetics ; Lung Neoplasms/secondary ; Magnetic Resonance Imaging ; Middle Aged ; Positron-Emission Tomography ; Repressor Proteins/genetics ; Sarcoma/diagnostic imaging ; Sarcoma/genetics ; Sarcoma/secondary ; Soft Tissue Neoplasms/genetics ; Soft Tissue Neoplasms/pathology ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed

مستخلص: Background: Ewing-like sarcoma with capicua transcriptional repressor (CIC) rearrangement is a unique class of undifferentiated round cell sarcomas characterized by CIC-double homeobox 4 gene fusion. Despite showing great histologic resemblance to Ewing sarcomas, they have proved to be a distinct pathological entity from the immunohistochemistry and genetic examinations and the response to treatment. We have presented a case of CIC-rearranged Ewing-like sarcoma with cerebral metastasis managed with operative resection and gamma knife radiosurgery.
Case Description: A 56-year-old woman had initially presented with an ulcerating lesion of the right fifth toe. The histological and immunohistochemical analysis revealed features consistent with CIC-rearranged Ewing-like sarcoma, which was confirmed with genetic analysis. Despite aggressive local control and a multidrug chemotherapy regimen, the patient developed multifocal metastases involving the lungs, femur, and cerebrum. The cerebral lesions were managed with surgery and gamma knife radiosurgery, with mixed results.
Conclusion: CIC-rearranged Ewing-like sarcomas have recently been recognized as a distinct disease entity with a highly aggressive course. Treatment paradigms have yet to be defined to properly manage such an aggressive pathological process.
(Copyright © 2020 Elsevier Inc. All rights reserved.)

المؤلفون: Zhang J; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Xue W; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Xu K; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Yi L; Department of Neurosurgery, Daping Hospital, Army Medical University, Chongqing, 400042, China., Guo Y; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Xie T; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Tong H; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Zhou B; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Wang S; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Li Q; Department of Oncology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Liu H; Department of Radiology, PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China., Chen X; Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, 400042, China., Fang J; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China., Zhang W; Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China.; Chongqing Clinical Research Center of Imaging and Nuclear Medicine, Chongqing, 400042, China.

المصدر: Theranostics [Theranostics] 2020 Jun 05; Vol. 10 (16), pp. 7245-7259. Date of Electronic Publication: 2020 Jun 05 (Print Publication: 2020).

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Ivyspring International Publisher Country of Publication: Australia NLM ID: 101552395 Publication Model: eCollection Cited Medium: Internet ISSN: 1838-7640 (Electronic) Linking ISSN: 18387640 NLM ISO Abbreviation: Theranostics Subsets: MEDLINE

مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*therapeutic use , Brain Neoplasms/*drug therapy , Glioblastoma/*drug therapy , Neovascularization, Pathologic/*diagnosis, Animals ; Antineoplastic Combined Chemotherapy Protocols/pharmacology ; Apoptosis/drug effects ; Bevacizumab/pharmacology ; Bevacizumab/therapeutic use ; Brain/blood supply ; Brain/diagnostic imaging ; Brain/drug effects ; Brain/pathology ; Brain Neoplasms/blood supply ; Brain Neoplasms/diagnosis ; Brain Neoplasms/pathology ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Drug Synergism ; Glioblastoma/blood supply ; Glioblastoma/diagnosis ; Glioblastoma/pathology ; Human Umbilical Vein Endothelial Cells ; Humans ; Lactic Acid/analysis ; Lactic Acid/metabolism ; Male ; Mice ; Multiparametric Magnetic Resonance Imaging ; Neovascularization, Pathologic/drug therapy ; Neovascularization, Pathologic/pathology ; Phosphofructokinase-2/antagonists & inhibitors ; Phosphofructokinase-2/metabolism ; Pyridines/pharmacology ; Pyridines/therapeutic use ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Vascular Endothelial Growth Factor A/metabolism ; Xenograft Model Antitumor Assays

مستخلص: Rationale: Tumor vascular normalization (TVN) is emerging to enhance the efficacy of anticancer treatment in many cancers including glioblastoma (GBM). However, a common and severe challenge being currently faced is the transient TVN effect, hampering the sustained administration of anticancer therapy during TVN window. Additionally, the lack of non-contrast agent-based imaging biomarkers to monitor TVN process postpones the clinical translation of TVN strategy. In this study, we investigated whether dual inhibition of VEGF and the glycolytic activator PFKFB3 could reinforce the TVN effect in GBM. Dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) and intravoxel incoherent motion (IVIM)-MRI were performed to monitor TVN process and to identify whether IVIM-MRI is a candidate or complementary imaging biomarker for monitoring TVN window without exogenous contrast agent administration. Methods: Patient-derived orthotopic GBM xenografts in mice were established and treated with bevacizumab (BEV), 3PO (PFKFB3 inhibitor), BEV+3PO dual therapy, or saline. The vascular morphology, tumor hypoxia, and lactate level were evaluated before and at different time points after treatments. Doxorubicin was used to evaluate chemotherapeutic efficacy and drug delivery. Microarray of angiogenesis cytokines and western blotting were conducted to characterize post-treatment molecular profiling. TVN process was monitored by DCE- and IVIM-MRI. Correlation analysis of pathological indicators and MRI parameters was further analyzed. Results: Dual therapy extended survival and delayed tumor growth over each therapy alone, concomitant with a decrease of cell proliferation and an increase of cell apoptosis. The dual therapy reinforces TVN effect, thereby alleviating tumor hypoxia, reducing lactate production, and improving the efficacy and delivery of doxorubicin. Mechanistically, several angiogenic cytokines and pathways were downregulated after dual therapy. Notably, dual therapy inhibited Tie1 expression, the key regulator of TVN, in both endothelial cells and tumor cells. DCE- and IVIM-MRI data showed that dual therapy induced a more homogenous and prominent TVN effect characterized by improved vascular function in tumor core and tumor rim. Correlation analysis revealed that IVIM-MRI parameter D ^* had better correlations with TVN pathological indicators compared with the DCE-MRI parameter K ^trans has much potential as a complementary imaging biomarker to monitor TVN window more precisely without exogenous contrast agent injection.Conclusions: Our results propose a rationale to overcome the current limitation of BEV monotherapy by integrating the synergistic effects of VEGF and PFKFB3 blockade to enhance chemotherapy efficacy through a sustained TVN effect. Moreover, we unveil IVIM-MRI parameter D ^* has much potential as a complementary imaging biomarker to monitor TVN window more precisely without exogenous contrast agent injection.
Competing Interests: Competing Interests: The authors have declared that no competing interest exists.
(© The author(s).)

المؤلفون: Gerstner ER; Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts. egerstner@mgh.harvard.edu.; Harvard Medical School, Boston, Massachusetts., Emblem KE; Department of Diagnostic Physics, Oslo University, Oslo, Norway., Chang K; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts., Vakulenko-Lagun B; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts., Yen YF; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts., Beers AL; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts., Dietrich J; Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts.; Harvard Medical School, Boston, Massachusetts., Plotkin SR; Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts.; Harvard Medical School, Boston, Massachusetts., Catana C; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts., Hooker JM; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts., Duda DG; Harvard Medical School, Boston, Massachusetts.; Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts., Rosen B; Harvard Medical School, Boston, Massachusetts.; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts., Kalpathy-Cramer J; Harvard Medical School, Boston, Massachusetts.; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts., Jain RK; Harvard Medical School, Boston, Massachusetts.; Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts., Batchelor T; Harvard Medical School, Boston, Massachusetts.; Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts.

المصدر: Clinical cancer research : an official journal of the American Association for Cancer Research [Clin Cancer Res] 2020 Jan 01; Vol. 26 (1), pp. 206-212. Date of Electronic Publication: 2019 Sep 26.

نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: The Association Country of Publication: United States NLM ID: 9502500 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-3265 (Electronic) Linking ISSN: 10780432 NLM ISO Abbreviation: Clin Cancer Res Subsets: MEDLINE

مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*therapeutic use , Brain Neoplasms/*drug therapy , Capillary Permeability/*drug effects , Glioblastoma/*drug therapy , Neoplasm Recurrence, Local/*drug therapy, Adult ; Aged ; Bevacizumab/administration & dosage ; Brain Neoplasms/metabolism ; Brain Neoplasms/pathology ; Chemotherapy, Cancer, Regional Perfusion ; Female ; Glioblastoma/metabolism ; Glioblastoma/pathology ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Neoplasm Recurrence, Local/metabolism ; Neoplasm Recurrence, Local/pathology ; Positron-Emission Tomography/methods ; Prognosis ; Temozolomide/administration & dosage

مستخلص: Purpose: Targeting tumor blood vessels is an attractive therapy in glioblastoma (GBM), but the mechanism of action of these agents and how they modulate delivery of concomitant chemotherapy are not clear in humans. We sought to elucidate how bevacizumab modulates tumor vasculature and the impact those vascular changes have on drug delivery in patients with recurrent GBM.
Experimental Design: Temozolomide was labeled with [11C], and serial PET-MRI scans were performed in patients with recurrent GBM treated with bevacizumab and daily temozolomide. PET-MRI scans were performed prior to the first bevacizumab dose, 1 day after the first dose, and prior to the third dose of bevacizumab. We calculated tumor volume, vascular permeability ( K trans ), perfusion (cerebral blood flow), and the standardized uptake values (SUV) of [11C] temozolomide within the tumor.
Results: Twelve patients were enrolled, resulting in 23 evaluable scans. Within the entire contrast-enhancing tumor volume, both temozolomide uptake and vascular permeability decreased after initiation of bevacizumab in most patients, whereas change in perfusion was more variable. In subregions of the tumor where permeability was low and the blood-brain barrier not compromised, increased perfusion correlated with increased temozolomide uptake.
Conclusions: Bevacizumab led to a decrease in permeability and concomitant delivery of temozolomide. However, in subregions of the tumor where permeability was low, increased perfusion improved delivery of temozolomide, suggesting that perfusion may modulate the delivery of chemotherapy in certain settings. These results support exploring whether lower doses of bevacizumab improve perfusion and concomitant drug delivery.
(©2019 American Association for Cancer Research.)

المؤلفون: Kebir S; Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany. Sied.Kebir@uk-essen.de.; West German Cancer Center (WTZ), University Hospital Essen and German Cancer Consortium, Partner Site University Hospital Essen, University Duisburg-Essen, Essen, Germany. Sied.Kebir@uk-essen.de.; Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. Sied.Kebir@uk-essen.de., Schaub C; Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany., Junold N; Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany., Hattingen E; Institute of Neuroradiology, University of Frankfurt, Frankfurt, Germany., Schäfer N; Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany., Steinbach JP; Dr. Senckenberg Institute of Neurooncology, University of Frankfurt, Frankfurt, Germany., Weyerbrock A; Department of Neurosurgery, University of Freiburg, Freiburg, Germany., Hau P; Department of Neurology and Wilhelm Sander Neurooncology Unit, University of Regensburg, Regensburg, Germany., Goldbrunner R; Center for Neurosurgery, University of Cologne, Cologne, Germany., Galldiks N; Department of Neurology, University of Cologne, Cologne, Germany.; Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany., Weller J; Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany., Mack F; Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany., Tzaridis T; Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany., Bähr O; Dr. Senckenberg Institute of Neurooncology, University of Frankfurt, Frankfurt, Germany., Seidel C; Department of Radiation Oncology, University of Leipzig, Leipzig, Germany., Schlegel U; Department of Neurology, Knappschaftskrankenhaus Klinikum Der Ruhr-Universität Bochum, Bochum, Germany., Schmidt-Graf F; Department of Neurology, Klinikum Rechts Der Isar, Technical University of Munich (TUM), Munich, Germany., Rohde V; Department of Neurosurgery, Georg-August-University, Göttingen, Germany., Borchers C; Department of Neurology, Nordwest-Krankenhaus Sanderbusch, Sande, Germany., Tabatabai G; Interdisciplinary Division of Neuro-Oncology, Departments of Neurology & Neurosurgery, Hertie Institute for Clinical Brain Research, University Hospital Tübingen, Eberhard Karls University Tübignen, Tübingen, Germany., Hänel M; Department of Internal Medicine III, Klinikum Chemnitz gGmbH, Chemnitz, Germany., Sabel M; Department of Neurosurgery, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Germany., Gerlach R; Department of Neurosurgery, HELIOS Klinikum Erfurt, Erfurt, Germany., Krex D; Department of Neurosurgery, Technical University Dresden, Dresden, Germany., Belka C; Department of Radiation Oncology, LMU Munich, Munich, Germany., Vatter H; Department of Neurosurgery, University of Bonn Medical Center, Bonn, Germany., Proescholdt M; Department of Neurosurgery, University of Regensburg, Regensburg, Germany., Glas M; Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany.; West German Cancer Center (WTZ), University Hospital Essen and German Cancer Consortium, Partner Site University Hospital Essen, University Duisburg-Essen, Essen, Germany.; Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany., Herrlinger U; Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany.

المصدر: Journal of neuro-oncology [J Neurooncol] 2019 Sep; Vol. 144 (3), pp. 501-509. Date of Electronic Publication: 2019 Jul 19.

نوع المنشور: Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial

بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 8309335 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-7373 (Electronic) Linking ISSN: 0167594X NLM ISO Abbreviation: J Neurooncol Subsets: MEDLINE

مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*therapeutic use , Brain Neoplasms/*mortality , Glioblastoma/*mortality , Magnetic Resonance Imaging/*methods, Adult ; Aged ; Bevacizumab/administration & dosage ; Brain Neoplasms/drug therapy ; Brain Neoplasms/pathology ; Camptothecin/administration & dosage ; Dacarbazine/administration & dosage ; Female ; Follow-Up Studies ; Glioblastoma/drug therapy ; Glioblastoma/pathology ; Humans ; Irinotecan/administration & dosage ; Male ; Middle Aged ; Prognosis ; Survival Rate ; Temozolomide/administration & dosage

مستخلص: Purpose: The phase II GLARIUS trial assigned patients with newly diagnosed, O-6-methylguanine-DNA methyltransferase promoter non-methylated glioblastoma to experimental bevacizumab/irinotecan (BEV/IRI) or standard temozolomide (TMZ). To identify subpopulations with a particularly favorable course, we assessed the prognostic potential of magnetic resonance imaging (MRI) markers before treatment onset.
Methods: MRIs at baseline (before treatment onset) were analyzed for T1-hyperintense and diffusion-restricted lesions; as well as the presence of both hyperintense and diffusion-restricted (double positive) lesions. The MRI findings were correlated with overall and progression-free survival.
Results: MRI scans were evaluable in 71% of the GLARIUS modified intention-to-treat population (n = 121 of 170; 88 patients in the BEV/IRI arm, and 33 patients in the TMZ control arm). Diffusion-restricted and T1 hyperintense lesions were present in 60% and 65% of patients in BEV/IRI arm, while 57% and 63% were found in the TMZ arm, respectively. Double positive lesions were found in 37% of BEV/IRI patients and in 39% of TMZ patients. Neither the presence of T1-hyperintense, diffusion-restricted lesions, nor double positive lesions were associated with improved survival.
Conclusions: Baseline T1-hyperintense and diffusion-restricted lesions are not suitable to predict progression-free or overall survival of patients treated with bevacizumab/irinotecan or temozolomide.

المؤلفون: Sahu KK; Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA., Pandey D; Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA., Mishra AK; Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA., O'Shea J; Division of Hematology and Medical Oncology, Saint Vincent Hospital, Worcester, Massachusetts, USA., Chen Y; Department of Pathology, Saint Vincent Hospital, Worcester, Massachusetts, USA., McGregor B; Department of Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.

المصدر: BMJ case reports [BMJ Case Rep] 2019 Aug 26; Vol. 12 (8). Date of Electronic Publication: 2019 Aug 26.

نوع المنشور: Case Reports; Journal Article

بيانات الدورية: Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 101526291 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-790X (Electronic) Linking ISSN: 1757790X NLM ISO Abbreviation: BMJ Case Rep Subsets: MEDLINE

مواضيع طبية MeSH: Adenocarcinoma*/immunology , Adenocarcinoma*/pathology , Adenocarcinoma*/therapy , Antineoplastic Combined Chemotherapy Protocols*/administration & dosage , Antineoplastic Combined Chemotherapy Protocols*/adverse effects , Brain Neoplasms*/diagnostic imaging , Brain Neoplasms*/pathology , Brain Neoplasms*/secondary , Lymphatic Metastasis*/pathology , Lymphatic Metastasis*/therapy , Urinary Bladder Neoplasms*/immunology , Urinary Bladder Neoplasms*/pathology , Urinary Bladder Neoplasms*/therapy, Lymph Nodes/*pathology , Radiotherapy/*methods, Biopsy/methods ; Diagnosis, Differential ; Fluorouracil/administration & dosage ; Fluorouracil/adverse effects ; Humans ; Immunohistochemistry ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/adverse effects ; Leucovorin/administration & dosage ; Leucovorin/adverse effects ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Neck ; Neoplasm Staging ; Organoplatinum Compounds/administration & dosage ; Organoplatinum Compounds/adverse effects

مستخلص: We present the case of a 55-year-old male patient who presented with palpable cervical lymphadenopathy. Excisional biopsy showed metastatic adenocarcinoma of unknown origin. Imaging showed a bladder mass following which he underwent transurethral resection of bladder tumour. Histopathological evaluation of mass confirmed a poorly differentiated adenocarcinoma with signet-ring cell features. Immunohistochemistry was suggestive of metastatic urachal cancer. He agreed for enrollment in a clinical trial, however soon after 1st cycle, he developed immune pneumonitis requiring high dose steroids. On follow-up, MRI brain was done for evaluation of headache which showed metastatic intracranial disease. He completed radiotherapy following which he was started on FOLFOX chemo regimen (folinic acid, 5-fluorouracil and oxaliplatin).
Competing Interests: Competing interests: None declared.
(© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

SCR Disease Name: Urachal cancer

SCR Protocol: Folfox protocol