Reduced folate carrier (RFC) as a predictive marker for response to pemetrexed in advanced non-small cell lung cancer (NSCLC).

INTRODUCTION: RFC is the major transport system in mammalian cells for folate cofactors and antifolate therapeutics. The aim of this study was to assess the predictive value of RFC expression in patients receiving pemetrexed for advanced NSCLC. METHODS: The study was carried out in a population of 48 patients with advanced NSCLC which have received pemetrexed monotherapy in second and third line. RFC expression was assessed using a two-step model of immunohistochemical staining in paraffin-embedded tissue samples. RESULTS: RFC expression was detected in 16 (33 %) patients. In the global population, the median progression free survival (PFS) and the median overall survival (OS) were 3.3 and 6.5 months respectively. The subgroup of patients with expression of RFC had a tendency to better median PFS (4.5 vs 2.8 months; p = 0.926) and median OS (11.7 vs 4.8; p = 0.150). In patients with adenocarcinoma histology and RFC expression median OS after treatment with pemetrexed was 14.4 months versus 5.0 in those with adenocarcinoma but without RFC expression (p = 0.039). CONCLUSIONS: These results suggest the possible relation between RFC expression and response to treatment with antifolates (pemetrexed) independently of the tumor histology. Further studies are required to confirm these results.

Zosteriform cutaneous metastasis from a breast carcinoma

Las metástasis cutáneas de carcinomas internos son infrecuentes y con patrón zosteriforme son raras. Para estudiar las características de las metástasis zosteriformes estudiamos 38 casos de la literatura y una paciente vista en nuestro Servicio. Métodos: Estudiamos la edad y sexo de cada paciente, la localización del tumor primario, la anatomía patológica del primario y las lesiones cutáneas, localización de las lesiones cutáneas y presencia o ausencia de dolor en los 39 casos. Resultados: La localización más frecuente del cáncer primario fue la mama (7 pacientes) y el carcinoma escamoso de piel (6 pacientes). El sitio más común de las metástasis en la piel fue la pared abdominal (21 pacientes). Conclusión: Esta revisión realza la importancia de incluir las metástasis cutáneas dentro del diagnóstico diferencial de las enfermedades con distribución zosteriforme. Se deben considerar las metástasis cutáneas y es necesario realizar una biopsia de piel para confirmar el diagnóstico. Nosotros pensamos que este patrón de enfermedad metastásica es más frecuente de lo recogido en la literatura

Cutaneous metastases from internal malignancies or primary skin cancers are uncommon, and a zosteriform pattern is very rare. In order to elucidate the characteristics of zosteriform metastatic skin cancer we reviewed 38 cases from the medical literature and 1 case seen in our clinic. Methods: The age and sex of each patient, location of the primary tumor, pathology of primary and metastatic lesions, location of the skin cancer and presence of pain were determined for the 39 cases. Results: The most frequent site of the primary tumor was the breast (7 cases) and skin squamous all carcinoma (6 cases). The most common site of the skin metastases was the chest wall (21 cases). Conclusion: This review highlights the importance of including cutaneous metastases within the differential diagnosis of zosteriform eruptions. Skin metastases should be considered and a skin biopsy is necessary to confirm the diagnosis. We think that this pattern of metastatic disease is more frequent than is indicated in the literature