Early Detection of Pancreatic Cancer.

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy that is increasingly common. Screening for pancreatic cancer is not well established but might increase the chance of detection in early stages. SUMMARY: We conducted a literature search to summarize current recommendations and to give an overview of patient groups that may benefit from screening. In the general population, screening is not recommended because the low prevalence of PDAC renders any diagnostic tests non-predictive and because there is no direct evidence that links early diagnosis to improved survival. To date, novel approaches like liquid biopsies and molecular markers are not yet able to improve screening in unselected individuals but offer promising potential. Screening efficiency increases considerably with increasing pretest probability. Therefore, the best way to improve early diagnosis is identifying high-risk individuals. KEY MESSAGES: There are well-defined populations with distinct genetic alterations with an increased risk for pancreatic cancer. Those may be screened with common diagnostic methods. In addition, new-onset diabetes is increasingly recognized as an early symptom, especially in elderly patients with weight loss.

Crizotinib: aseptic abscesses in multiple organs during treatment of EML4-ALK-positive NSCLC.

PURPOSE: We report a novel side effect of Crizotinib, an oral ALK inhibitor used in the treatment of non-small cell lung cancer (NSCLC) with activating rearrangement of EML4-ALK. It expands the known spectrum of complications of Crizotinib. METHODS: Clinical case report. RESULTS: Multiple aseptic and recurrent abscesses were observed in the liver, thoracic wall as well as in both kidneys in a 75-year-old female patient suffering from NSCLC who had been treated with Crizotinib for almost 2 years. After discontinuation of the treatment the abscesses dissolved spontaneously and did not reoccur. CONCLUSION: Aseptic abscesses under treatment with Crizotinib are not restricted to the kidneys as described before, but can also occur in other abdominal organs as the liver and even in the thoracic wall. We postulate that this finding may point to a yet unknown not tissue-dependent mechanism of action.