1
|
Blaquier JB, Recondo G. Osimertinib and chemotherapy combination to treat brain metastasis flare and osimertinib resistance by EGFR C797S. J Chemother 2022; 35:168-172. [PMID: 35467492 DOI: 10.1080/1120009x.2022.2067705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Chemotherapy or involvement in a clinical trial remain the standard treatment for patients with EGFR mutant non-small cell lung cancer who have disease progression while receiving Osimertinib. Rapid progression, also known as flare-phenomenon, has been described after discontinuation of tyrosine kinase inhibitors. In this case, we describe a young woman who has extracranial progressive disease due to EGFR C797S resistance mutation while being treated with osimertinib, with a rapid neurological deterioration after osimertinib withdrawal due to flare-phenomenon progression in the brain, and a prompt intracranial response with osimertinib reintroduction in addition to chemotherapy to achieve extracranial diseases control.
Collapse
Affiliation(s)
- Juan Bautista Blaquier
- Clinical Oncology Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Gonzalo Recondo
- Clinical Oncology Section, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| |
Collapse
|
2
|
Moiseyenko FV, Moiseyenko VM, Aleksakhina SN, Chubenko VA, Volkov NM, Kozyreva KS, Kramchaninov MM, Zhuravlev AS, Shelekhova KV, Ivantsov AO, Venina AR, Preobrazhenskaya EV, Mitiushkina NV, Iyevleva AG, Imyanitov EN. Survival Outcomes in EGFR Mutation-Positive Lung Cancer Patients Treated with Gefitinib until or beyond Progression. Oncol Res Treat 2016; 39:605-614. [DOI: 10.1159/000449024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 07/28/2016] [Indexed: 11/19/2022]
|
3
|
Funatsu Y, Hirayama M, Shiraishi J, Asakura T, Wakaki M, Yamada E, Fujimoto K, Satomi R, Inaki S, Murata Y, Oyamada Y. Intimal Sarcoma of the Pulmonary Artery Treated with Pazopanib. Intern Med 2016; 55:2197-202. [PMID: 27522994 DOI: 10.2169/internalmedicine.55.6199] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Intimal sarcoma is a rare disease with a poor prognosis. We herein report the case of a 71-year-old man with intimal sarcoma of the pulmonary artery treated with pazopanib. The tumor showed regression after 1 month of treatment. Hand-foot syndrome led to cessation of pazopanib, which triggered a disease flare. Pazopanib should be considered in patients with intimal sarcoma of the pulmonary artery that is unresectable or recurrent after surgery or cytotoxic chemotherapy. We must be careful about drug cessation, as it can lead to a disease flare.
Collapse
Affiliation(s)
- Yohei Funatsu
- Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Zhang R, Tu L, Sun L. Tyrosine kinase inhibitors re-treatment beyond progression: choice and challenge. J Thorac Dis 2014; 6:595-7. [PMID: 24976979 DOI: 10.3978/j.issn.2072-1439.2014.04.36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 04/21/2014] [Indexed: 11/14/2022]
Abstract
Tyrosine kinase inhibitors (TKIs) are highly effective agents for the treatment of lung cancer which harbors activated gene mutation. However, for patients with failure of TKI, TKI re-treatment beyond progression (TRBP) is still a potential option that has been proven by many literatures. In this review, we summarize the clinical evidence of TRBP and discuss the potential mechanisms to overcome TKI-acquired resistance.
Collapse
Affiliation(s)
- Ru Zhang
- 1 Department of Gerontology, Chengdu Military General Hospital, Chengdu 610083, China ; 2 Department of Oncology, the People's Hospital of Bishan County, Bishan, Chongqing 402760, China
| | - Lingli Tu
- 1 Department of Gerontology, Chengdu Military General Hospital, Chengdu 610083, China ; 2 Department of Oncology, the People's Hospital of Bishan County, Bishan, Chongqing 402760, China
| | - Lan Sun
- 1 Department of Gerontology, Chengdu Military General Hospital, Chengdu 610083, China ; 2 Department of Oncology, the People's Hospital of Bishan County, Bishan, Chongqing 402760, China
| |
Collapse
|
5
|
Mariano C, Bosdet I, Karsan A, Ionescu D, Murray N, Laskin JJ, Zhai Y, Melosky B, Sun S, Ho C. A population-based review of the feasibility of platinum-based combination chemotherapy after tyrosine kinase inhibition in EGFR mutation positive non-small cell lung cancer patients with advanced disease. Lung Cancer 2014; 83:73-7. [DOI: 10.1016/j.lungcan.2013.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 10/05/2013] [Accepted: 10/08/2013] [Indexed: 11/29/2022]
|
6
|
Cadranel J, Ruppert AM, Beau-Faller M, Wislez M. Therapeutic strategy for advanced EGFR mutant non-small-cell lung carcinoma. Crit Rev Oncol Hematol 2013; 88:477-93. [DOI: 10.1016/j.critrevonc.2013.06.009] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 05/23/2013] [Accepted: 06/26/2013] [Indexed: 12/23/2022] Open
|
7
|
Kuriyama Y, Kim YH, Nagai H, Ozasa H, Sakamori Y, Mishima M. Disease flare after discontinuation of crizotinib in anaplastic lymphoma kinase-positive lung cancer. Case Rep Oncol 2013; 6:430-3. [PMID: 24019783 PMCID: PMC3764956 DOI: 10.1159/000354756] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
We report the case of a 50-year-old male former smoker. He was diagnosed as having lung adenocarcinoma and treated with induction chemoradiation therapy followed by surgery and adjuvant chemotherapy. Molecular testing revealed that his tumor had an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) rearrangement. Therefore, he was treated with crizotinib when his disease recurred. He achieved a partial response, which persisted for 10 months until progressive disease was confirmed. Crizotinib was continued for 1 month and the tumor size increased slightly. At that time, crizotinib was discontinued and he participated in a clinical trial of erlotinib ± Met inhibitor; however, his disease progressed rapidly after discontinuation of crizotinib, and the diagnosis of disease flare was made. Readministration of crizotinib was started immediately; however, his disease progressed rapidly, and he died 2 days after starting crizotinib retreatment. Currently, the incidence of disease flare is unknown and it is impossible to predict who will experience it. Therefore, continuing crizotinib after disease progression may be a reasonable option to avoid disease flare.
Collapse
Affiliation(s)
- Yuka Kuriyama
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | | | | | | | | |
Collapse
|
8
|
Chen HJ, Yan HH, Yang JJ, Chen ZH, Su J, Zhang XC, Wu YL. Disease Flare After EGFR Tyrosine Kinase Inhibitor Cessation Predicts Poor Survival in Patients with Non-small Cell Lung Cancer. Pathol Oncol Res 2013; 19:833-8. [DOI: 10.1007/s12253-013-9651-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 05/02/2013] [Indexed: 01/24/2023]
|
9
|
Araya T, Kasahara K, Demura Y, Matsuoka H, Nishitsuji M, Nishi K. Successful treatment with erlotinib of severe neutropenia induced by gefitinib in a patient with advanced non-small cell lung cancer. Lung Cancer 2013; 80:344-6. [PMID: 23489558 DOI: 10.1016/j.lungcan.2013.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 02/10/2013] [Accepted: 02/16/2013] [Indexed: 10/27/2022]
Abstract
Neutropenia is a rare side effect of gefitinib and was scarcely reported in many large-scale randomized phase III trials using gefitinib monotherapy as first-line treatment. A 77-year-old female was referred to our institution due to abnormal shadow of the right lung, diagnosed by CT scan and biopsy histopathology as adenocarcinoma of the lung (cT3N1M1b). Mutation analysis with PCR-Invader assay of tumor DNA samples revealed short in-frame deletion in exon 19. Based on the diagnosis, first-line treatment was initiated using oral gefitinib (250 mg, daily). During the initial 27 days of gefitinib therapy, the only side effect was a mild skin rash. After 28 days, there was marked tumor shrinkage, indicative of a partial response to gefitinib; however, grade 4 neutropenia was also detected. The patient was switched to the oral erlotinib monotherapy (150 mg/day) as second-line chemotherapy with careful monitoring of neutropenia. Discontinuation of the gefitinib, without the need for granulocyte colony-stimulating factor support, was successful in allowing the neutrophils and leukocytes counts to recover to normal by day 47. The patient continued oral erlotinib for more than 9 months and there has been no evidence of neutropenia, leukopenia, or disease progression. Clinicians should be aware that gefitinib-induced neutropenia in patients with non-small cell lung cancer can be treated successful by switching to erlotinib.
Collapse
Affiliation(s)
- Tomoyuki Araya
- Department of Respiratory Medicine, Ishikawa Prefectural Central Hospital, 2-1 Kuratsuki-Higashi, Kanazawa 920-8530, Japan.
| | | | | | | | | | | |
Collapse
|
10
|
Tu L, Sun L. Re-challenge treatment of small-molecular inhibitors in NSCLC patients beyond progression. J Thorac Dis 2012. [PMID: 23205294 DOI: 10.3978/j.issn.2072-1439.2012.10.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Lingli Tu
- Division of Thoracic Cancer, Cancer Center, West China Hospital, West China School of Clinical Medicine, Sichuan University, Chengdu, China
| | | |
Collapse
|
11
|
De Grève J, Decoster L, van Brummelen D, Geers C, Schallier D. Is there a third line option after chemotherapy and TKI failure in advanced non-small cell lung cancer? Transl Lung Cancer Res 2012; 1:152-4. [PMID: 25806173 PMCID: PMC4367571 DOI: 10.3978/j.issn.2218-6751.2012.06.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 06/11/2012] [Indexed: 12/18/2022]
Affiliation(s)
- Jacques De Grève
- Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Lore Decoster
- Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - David van Brummelen
- Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Caroline Geers
- Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Denis Schallier
- Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| |
Collapse
|