Four lines of anaplastic lymphoma kinase inhibitors and brain radiotherapy in a long-surviving non-small-cell lung cancer anaplastic lymphoma kinase-positive patient with leptomeningeal carcinomatosis

Lung cancer is the most common tumor and the leading cause of cancer-related death worldwide. Approximately 6.7% of non-small-cell lung cancers (NSCLCs) show anaplastic lymphoma kinase (ALK) rearrangement and could benefit from ALK-targeted treatment. Various anti-ALK drugs have been developed during the past years, but it is actually controversial which sequence and which ALK inhibitor is recommended for a single patient. Leptomeningeal carcinomatosis (LC) is associated with a poor prognosis, with an overall survival of 2–4 months for treated patients. The data about LC management derive mainly from retrospective studies, being an exclusion criterion for most trials. Intrathecal chemotherapy and whole-brain radiotherapy (WBRT), associated with a systemic treatment, are the most commonly used approach. Here we present a case of NSCLC harboring an ALK translocation treated with four lines of ALK inhibitors and receiving WBRT for LC, showing an overall survival of ∼5 years from the diagnosis of metastatic disease. This case report focuses mainly on several controversial clinical aspects, that is, the sequence of treatment in ALK-positive NSCLC, the ALK inhibitors’ efficacy on brain disease and beyond progression, the management of LC, and the role of WBRT despite the risk of cognitive impairment.
Source: Anti-Cancer Drugs - Category: Cancer & Oncology Tags: CASE REPORTS Source Type: research

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ConclusionsThe relevance of SPARC expression in pancreato-biliary carcinomas though may still be important for therapeutic decision making, it is not responsible for peritumoral stromal desmoplasia in these tumors and it does not have any significant prognostic implication.
Source: Pathology Research and Practice - Category: Pathology Source Type: research
We present for the first time a case of MFS of the breast induced by radiotherapy.
Source: Pathology Research and Practice - Category: Pathology Source Type: research
Source: BMJ Comments - Category: General Medicine Source Type: forums
Publication date: Available online 20 October 2019Source: The LancetAuthor(s): Daniel I Sessler, Lijian Pei, Yuguang Huang, Edith Fleischmann, Peter Marhofer, Andrea Kurz, Douglas B Mayers, Tanja A Meyer-Treschan, Martin Grady, Ern Yu Tan, Sabry Ayad, Edward J Mascha, Donal J Buggy, Gang Tan, Zhiyong Zhang, Helen Keane, Maurice Stokes, Oliver Zotti, Michael Gnant, Silvia Perez-ProttoSummaryBackgroundThree perioperative factors impair host defence against recurrence during cancer surgery: the surgical stress response, use of volatile anaesthetic, and opioids for analgesia. All factors are ameliorated by regional anaesthesia...
Source: The Lancet - Category: General Medicine Source Type: research
CCR Grand Rounds Dr. Jabado ’ s research focuses on elucidating genetic signatures of pediatric astrocytomas and examining how they compare to adults. These are deadly brain tumors that originate in the brain and include glioblastomas (GBM, the highest grade of astrocytomas), which are one of the deadliest cancers in humans. Her group uncovered that pediatric high-grade astrocytomas (HGA) are molecularly and genetically distinct from adult tumors. They also identified a new molecular mechanism driving pediatric HGA, namely recurrent somatic driver mutations in the tail of histone 3 variants (H3.3 and H3.1). These mut...
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
Publication date: Available online 20 October 2019Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): R. Sacco, S. Shah, R. Leeson, V. Moraschini, C.F. de Almeida Barros Mourão, O. Akintola, A. LalliAbstractTumour necrosis factor-α (TNF-α) inhibitors are increasingly being used as immunomodulators to manage inflammatory conditions such as rheumatoid arthritis and Crohn’s disease. Reported serious side effects include an increased incidence of lymphoma and greater susceptibility to infections such as tuberculosis. The aim of this systematic review was to find out whether there is an ...
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
Publication date: December 2019Source: Biomedicine &Pharmacotherapy, Volume 120Author(s): Tiantian Cai, Chengzhe Zhang, Xiaohui Zeng, Ziming Zhao, Yan Yan, Xuhua Yu, Lei Wu, Lin Lin, Huafeng PanAbstractGastric cancer is recognized as one of the most common cancer. In-depth research of gastric precancerous lesions (GPL) plays an important role in preventing the occurrence of gastric cancer. Meanwhile, traditional treatment provides a novel sight in the prevention of occurrence and development of gastric cancer. The current study was designed to assess the effects of therapy with Weipixiao (WPX) decoction on N-methyl-N'-...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
Basosquamous carcinomas (BSCs), which comprise 1.2 –2.7% of skin carcinomas, are aggressive skin tumors that feature histopathologic characteristics of both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). BSC origin and genetic etiology remain controversial. Chiang and colleagues reported underlying PTCH and SMO mutations in BSCs, su ggesting that Hedgehog signaling drives BSC similar to BCC. Principal component analysis indicated that BSC has greater genetic similarity to BCC than to SCC, supporting the concept that BSCs are derived from BCCs.
Source: Journal of Investigative Dermatology - Category: Dermatology Tags: Clinical Snippets Source Type: research
Basosquamous carcinoma (BSC) is a rare form of skin cancer with both basaloid and squamous morphology. Chiang et  al. (2019) genetically define BSCs and demonstrate that BSCs likely originate as basal cell carcinomas that partially squamatize through accumulation of ARID1A mutations and RAS/MAPK pathway activation.
Source: Journal of Investigative Dermatology - Category: Dermatology Authors: Tags: Commentary Source Type: research
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Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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