Bożena Cybulska-Stopa, Adam Antczak, Dariusz M. Kowalski, Beata Kos-Kudła, Tomasz Kubiatowski, Przemysław Leszek, Adam Maciejczyk, Jarosław Reguła, Paweł Wiechno, Piotr Rutkowski
{"title":"Common statement of experts of the Polish Oncological Society, Polish Lung Cancer Group, Polish Society of Lung Diseases, Polish Society of Gastroenterology, Polish Society of Endocrinology, and the Polish Society of Cardiology for minimal requirements in diagnosis and monitoring of selected adverse events of immunotherapy in oncological patients","authors":"Bożena Cybulska-Stopa, Adam Antczak, Dariusz M. Kowalski, Beata Kos-Kudła, Tomasz Kubiatowski, Przemysław Leszek, Adam Maciejczyk, Jarosław Reguła, Paweł Wiechno, Piotr Rutkowski","doi":"10.5603/ocp.2022.0040","DOIUrl":"https://doi.org/10.5603/ocp.2022.0040","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135463825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Urakçı, S. Ebinç, Z. Oruç, Z. Kalkan, M. Kaplan, M. Küçüköner, A. Işıkdoğan
Introduction. Pemetrexed-based rechallenge therapies can be used as an option in the treatment of pleural mesothelioma. We aimed to investigate the efficacy of pemetrexed-based rechallenge in mesothelioma. Material and methods. A total of 132 patients who received chemotherapy for unresectable or metastatic pleural mesothelioma in the Medical Oncology Clinic of Dicle University Medical Faculty between 2005 and 2020 were included in our study. Pemetrexed plus platinum rechallenge treatments were compared with other chemotherapy regimens in terms of survival. Results. In our study, 31 (23.4%) of a total of 132 patients received rechallenge pemetrexed plus platinum treat - ment. There was no statistically significant difference between median progression-free survival of patients who received pemetrexed plus cisplatin or gemcitabine plus cisplatin in the first-line therapy [5 months vs. 8 months (HR = 1.43; 95% CI 0.59–3.45; p = 0.376)]. In the second-line treatment, patients who received rechallenge pemetrexed plus platinum therapy had statistically significantly higher median PFS than those who received gemcitabine plus platinum [6 months vs. 4 months (HR = 0.46; 95% CI: 0.22–0.94; p = 0.011)] due to a previ - ous good response. In the second-line treatment, median overall survival was 15 months with gemcitabine plus platinum and 29 months with pemetrexed plus platinum rechallenge (p = 0.007). Conclusions. This study demonstrated that the pemetrexed plus platinum regimen was more effective than gemcitabine plus platinum in the second-line treatment in terms of both progression-free and overall survival in patients who had previously benefited from pemetrexed-based chemotherapy and had not progressed up to 6 months after first-line treatment.
{"title":"Efficacy of pemetrexed plus a platinum rechallenge in the treatment of pleural mesothelioma","authors":"Z. Urakçı, S. Ebinç, Z. Oruç, Z. Kalkan, M. Kaplan, M. Küçüköner, A. Işıkdoğan","doi":"10.5603/ocp.2023.0014","DOIUrl":"https://doi.org/10.5603/ocp.2023.0014","url":null,"abstract":"Introduction. Pemetrexed-based rechallenge therapies can be used as an option in the treatment of pleural mesothelioma. We aimed to investigate the efficacy of pemetrexed-based rechallenge in mesothelioma. Material and methods. A total of 132 patients who received chemotherapy for unresectable or metastatic pleural mesothelioma in the Medical Oncology Clinic of Dicle University Medical Faculty between 2005 and 2020 were included in our study. Pemetrexed plus platinum rechallenge treatments were compared with other chemotherapy regimens in terms of survival. Results. In our study, 31 (23.4%) of a total of 132 patients received rechallenge pemetrexed plus platinum treat - ment. There was no statistically significant difference between median progression-free survival of patients who received pemetrexed plus cisplatin or gemcitabine plus cisplatin in the first-line therapy [5 months vs. 8 months (HR = 1.43; 95% CI 0.59–3.45; p = 0.376)]. In the second-line treatment, patients who received rechallenge pemetrexed plus platinum therapy had statistically significantly higher median PFS than those who received gemcitabine plus platinum [6 months vs. 4 months (HR = 0.46; 95% CI: 0.22–0.94; p = 0.011)] due to a previ - ous good response. In the second-line treatment, median overall survival was 15 months with gemcitabine plus platinum and 29 months with pemetrexed plus platinum rechallenge (p = 0.007). Conclusions. This study demonstrated that the pemetrexed plus platinum regimen was more effective than gemcitabine plus platinum in the second-line treatment in terms of both progression-free and overall survival in patients who had previously benefited from pemetrexed-based chemotherapy and had not progressed up to 6 months after first-line treatment.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"08 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79236959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Soni, Diptajit Paul, M. Verma, P. Kaur, A. Chauhan, V. Kaushal
{"title":"Male breast cancer: a budding and unaddressed issue","authors":"A. Soni, Diptajit Paul, M. Verma, P. Kaur, A. Chauhan, V. Kaushal","doi":"10.5603/ocp.2023.0008","DOIUrl":"https://doi.org/10.5603/ocp.2023.0008","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"2 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80914876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Krzyżanowska, P. Krawczyk, I. Chmielewska, T. Jankowski, K. Wojas-Krawczyk, J. Milanowski
Immunotherapy is a groundbreaking treatment method when it comes to cancer, and this includes non-small-cell lung cancer (NSCLC). In NSCLC patients, immunotherapy is used in a form of immune checkpoint inhibitors (ICIs), and depending on the proportion of tumor cells with programmed death ligand 1 (PD-L1) expression on them, it can be administered either in monotherapy ( ≥ 50%) or in combination with chemotherapy (< 50%). In this article, we would like to present a case of a female patient with Kirsten Rat Sarcoma Virus ( KRAS )-mutated lung adenocarcinoma who was responding to chemoimmunotherapy for a long time despite the presence of co-mutation in the Serine/Threonine Kinase 11 ( STK11 ) gene, known to worsen immunotherapy outcomes. In this patient, another mutation was found — in the nibrin ( NBN ) gene, which is of uncertain relevance, but it presumably could be connected to a better outcome as it encodes proteins involved in DNA repair. Deficiency in DNA repair may be marked by homologous recombination deficiency (HRD), and there already exists some evidence of better immunotherapy efficacy in patients with HRD. Considering the above, further investigation and thorough genetic diagnostics in NSCLC patients are required to fully understand the background of immunotherapy
{"title":"Efficacy of chemoimmunotherapy in a lung adenocarcinoma patient with mutations in the KRAS and STK11","authors":"N. Krzyżanowska, P. Krawczyk, I. Chmielewska, T. Jankowski, K. Wojas-Krawczyk, J. Milanowski","doi":"10.5603/ocp.2023.0012","DOIUrl":"https://doi.org/10.5603/ocp.2023.0012","url":null,"abstract":"Immunotherapy is a groundbreaking treatment method when it comes to cancer, and this includes non-small-cell lung cancer (NSCLC). In NSCLC patients, immunotherapy is used in a form of immune checkpoint inhibitors (ICIs), and depending on the proportion of tumor cells with programmed death ligand 1 (PD-L1) expression on them, it can be administered either in monotherapy ( ≥ 50%) or in combination with chemotherapy (< 50%). In this article, we would like to present a case of a female patient with Kirsten Rat Sarcoma Virus ( KRAS )-mutated lung adenocarcinoma who was responding to chemoimmunotherapy for a long time despite the presence of co-mutation in the Serine/Threonine Kinase 11 ( STK11 ) gene, known to worsen immunotherapy outcomes. In this patient, another mutation was found — in the nibrin ( NBN ) gene, which is of uncertain relevance, but it presumably could be connected to a better outcome as it encodes proteins involved in DNA repair. Deficiency in DNA repair may be marked by homologous recombination deficiency (HRD), and there already exists some evidence of better immunotherapy efficacy in patients with HRD. Considering the above, further investigation and thorough genetic diagnostics in NSCLC patients are required to fully understand the background of immunotherapy","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"23 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86638351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Płużański, A. Tysarowski, M. Kawecki, J. Kucharz, M. Krzakowski
{"title":"Use of next-generation sequencing in daily routine practice","authors":"A. Płużański, A. Tysarowski, M. Kawecki, J. Kucharz, M. Krzakowski","doi":"10.5603/ocp.2023.0001","DOIUrl":"https://doi.org/10.5603/ocp.2023.0001","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75781465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kahvecioglu, S. Yuce Sari, H. Yıldırım, Z. Arık, M. Gultekin, F. Yıldız
Objectives. Leptomeningeal metastasis (LM) of primary uterine cervical cancer is rare and treatment options are limited. In this case report and literature review, we aimed to present a patient with cervical cancer with LM and discuss previously reported cases in the literature. Case presentation. Our case was a 58-year-old patient who was initially diagnosed with metastatic primary uterine cervical cancer and treated with chemotherapy and chemoradiotherapy. During follow-up, she developed neurological symptoms, and LM was detected in the craniospinal regions. Cerebrospinal fluid cytology examination has confirmed metastatic disease. The patient was treated with concurrent intrathecal methotrexate and whole-brain radiotherapy (WBRT). A good clinical and cytological response was obtained. However, while intrathecal methotrexate was being continued after WBRT, she succumbed to hematological toxicity before the radiological response could be evaluated. Conclusions. LM is an extremely rare and catastrophic distant spread pattern in patients with cervical cancer. In the literature, a total of 26 patients were reported up to date. Median survival after detection of LM was nine weeks, including our case. Multimodal treatment combinations such as systemic and intrathecal chemotherapy and radiotherapy (RT) were used. However, most of these reports did not have detailed information about toxicity. Despite the combined use of aggressive treatment modalities, patients have limited survival and very high risks of hematologic toxicity. Concurrent use of intrathecal chemotherapy and radiotherapy should be avoided due to increased risk of morbidity.
{"title":"Leptomeningeal metastasis in primary uterine cervical cancer: a rare case and review of the literature","authors":"A. Kahvecioglu, S. Yuce Sari, H. Yıldırım, Z. Arık, M. Gultekin, F. Yıldız","doi":"10.5603/ocp.2023.0010","DOIUrl":"https://doi.org/10.5603/ocp.2023.0010","url":null,"abstract":"Objectives. Leptomeningeal metastasis (LM) of primary uterine cervical cancer is rare and treatment options are limited. In this case report and literature review, we aimed to present a patient with cervical cancer with LM and discuss previously reported cases in the literature. Case presentation. Our case was a 58-year-old patient who was initially diagnosed with metastatic primary uterine cervical cancer and treated with chemotherapy and chemoradiotherapy. During follow-up, she developed neurological symptoms, and LM was detected in the craniospinal regions. Cerebrospinal fluid cytology examination has confirmed metastatic disease. The patient was treated with concurrent intrathecal methotrexate and whole-brain radiotherapy (WBRT). A good clinical and cytological response was obtained. However, while intrathecal methotrexate was being continued after WBRT, she succumbed to hematological toxicity before the radiological response could be evaluated. Conclusions. LM is an extremely rare and catastrophic distant spread pattern in patients with cervical cancer. In the literature, a total of 26 patients were reported up to date. Median survival after detection of LM was nine weeks, including our case. Multimodal treatment combinations such as systemic and intrathecal chemotherapy and radiotherapy (RT) were used. However, most of these reports did not have detailed information about toxicity. Despite the combined use of aggressive treatment modalities, patients have limited survival and very high risks of hematologic toxicity. Concurrent use of intrathecal chemotherapy and radiotherapy should be avoided due to increased risk of morbidity.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"17 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90233558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Gałązka, A. Rudzińska, Grzegorz Rudzki, Katarzyna Szklener, S. Mańdziuk
{"title":"Hypopituitarism as a rare complication of lung cancer immunotherapy","authors":"J. Gałązka, A. Rudzińska, Grzegorz Rudzki, Katarzyna Szklener, S. Mańdziuk","doi":"10.5603/ocp.2023.0013","DOIUrl":"https://doi.org/10.5603/ocp.2023.0013","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"50 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85747690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Gil, I. Chmielewska, P. Krawczyk, Przemysław Niziński, M. Strzemski, J. Milanowski
This case report examines the effects of replacement of anaplastic lymphoma kinase inhibitor (ALKi) as a strategy to reduce drug toxicity in patients with non-small cell lung cancer (NSCLC) with ALK gene rearrangements. A 61-year-old female patient with lung adenocarcinoma encountered difficulties in ALK abnormalities diagnosis: the expression of abnormal ALK protein was not detected by the immunohistochemistry (IHC) assay, but ALK gene rearrangement was present in next generation sequencing (NGS) and fluorescence in situ hybridization (FISH) assays. The patient was initially treated with second-generation ALKi (alectinib). However, the patient experienced severe hepatotoxicity. She was successfully switched to brigatinib (another second-generation ALK inhibitor). During brigatinib therapy, a transient increase in creatinine kinase concentration was observed, which required brigatinib dose reduction. Effectiveness of both anti-ALK agents was observed (partial response to treatment, followed by disease stabilization). This case report illustrates the difficulties in diagnosing ALK gene rearrangements and the possibility of replacing ALK inhibitors without compromising treatment efficacy.
{"title":"Replacement of ALK inhibitors as an effective strategy for reducing drug toxicity in non-small cell lung cancer patients with ALK gene rearrangement","authors":"M. Gil, I. Chmielewska, P. Krawczyk, Przemysław Niziński, M. Strzemski, J. Milanowski","doi":"10.5603/ocp.2023.0011","DOIUrl":"https://doi.org/10.5603/ocp.2023.0011","url":null,"abstract":"This case report examines the effects of replacement of anaplastic lymphoma kinase inhibitor (ALKi) as a strategy to reduce drug toxicity in patients with non-small cell lung cancer (NSCLC) with ALK gene rearrangements. A 61-year-old female patient with lung adenocarcinoma encountered difficulties in ALK abnormalities diagnosis: the expression of abnormal ALK protein was not detected by the immunohistochemistry (IHC) assay, but ALK gene rearrangement was present in next generation sequencing (NGS) and fluorescence in situ hybridization (FISH) assays. The patient was initially treated with second-generation ALKi (alectinib). However, the patient experienced severe hepatotoxicity. She was successfully switched to brigatinib (another second-generation ALK inhibitor). During brigatinib therapy, a transient increase in creatinine kinase concentration was observed, which required brigatinib dose reduction. Effectiveness of both anti-ALK agents was observed (partial response to treatment, followed by disease stabilization). This case report illustrates the difficulties in diagnosing ALK gene rearrangements and the possibility of replacing ALK inhibitors without compromising treatment efficacy.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"24 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80524330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Nugraha, Putu Bihan Surya Kinanta, I. Wiratnaya
Giant cell tumor (GCT) accounts for 5% of all primary bone tumors and 20% of benign skeletal tumors. This case report presents the case of a 17-year-old female with a recurrent giant cell tumor and lung metastases. The patient received bisphosphonate therapy instead of surgery. The use of zoledronic acid for lung metastases from GCT may have conservatively improved clinical symptoms and radiological assessments can be achieved.
{"title":"Bisphosphonate treatment as a safe choice for treating lung metastases of recurrent giant cell tumor of bone","authors":"H. Nugraha, Putu Bihan Surya Kinanta, I. Wiratnaya","doi":"10.5603/ocp.2023.0007","DOIUrl":"https://doi.org/10.5603/ocp.2023.0007","url":null,"abstract":"Giant cell tumor (GCT) accounts for 5% of all primary bone tumors and 20% of benign skeletal tumors. This case report presents the case of a 17-year-old female with a recurrent giant cell tumor and lung metastases. The patient received bisphosphonate therapy instead of surgery. The use of zoledronic acid for lung metastases from GCT may have conservatively improved clinical symptoms and radiological assessments can be achieved.","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":"217 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89105839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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