[Pleural epithelioid hemangioendothelioma: a case report and review of the literature].

OBJECTIVE: To explore the etiology, clinical manifestation, diagnosis, differential diagnosis, management and prognosis of pleural epithelioid hemangioendothelioma. METHODS: The clinical data of a patient with pleural epithelioid hemangioend othelioma admitted to Peking Union Medical College Hospital were retrospectively analyzed and the related literature was reviewed. We searched databases PubMed, Embase, Ovid, Cochrane, Wanfang and Chinese National Knowledge infrastructure (CNKI) using the keyword "pleural epithelioid hemangioendothelioma" by December 2013. RESULTS: The patient was a 40-year-old male presented with chest pain, and his chest CT scan revealed thickening of the left pleura and left pleural effusion. Biopsy of the pleura showed epithelioid tumor cells, and immunohistochemistry was positive for CD31, CD34 and vimentin. From January 1975 to December 2013, 18 related articles were retrieved and 29 cases of pleural epithelioid hemangioendothelioma were reported. Among all 30 cases, there were 20 males and 10 females, ranging from 31 to 82 years old, and the average age was 50. 3 years old. The etiology of the disease remained unknown. Chest pain, cough, and dyspnea were the common symptoms. Computed tomography usually revealed pleural effusion and pleural thickening or mass. Histological examinations revealed mainly epithelioid cells. Immunohistochemical stains were positive for vascular endothelial markers. The mean survival time was 8.2 months. CONCLUSIONS: Pleural epithelioid hemangioendothelioma is rare and the etiology is unknown. Clinical and imaging manifestations are not specific, and diagnosis is relied on histological findings. It should be differentiated from adenocarcinoma, hemangiosarcoma, mesothelioma and pulmonary epithelioid hemangioendothelioma. There is no effective treatment and its prognosis is poorer than its pulmonary counterpart.

Pancreas-specific immune-related adverse events in patients with lung cancer: a case series study.

Immune-related adverse events (irAEs) are one of the key concerns in cancer patients treated with immune checkpoint inhibitors (ICIs). Among the various irAEs, pancreas-specific irAE is a rare but special one with a variety of manifestations, such as pancreatic enzymes elevation, pancreatitis as well as diabetes. The current study reported 22 pancreas-specific irAEs in 21 patients with lung cancer, including pancreatic injury in 13 patients, pancreatitis in four patients and diabetes mellitus in five patients.

[Box: see text].

Treatment with or without bevacizumab as a first-line and maintenance therapy for advanced non-squamous non-small cell lung cancer: A retrospective study.

BACKGROUND: Pemetrexed and bevacizumab as monotherapies, or in combination, have been approved for maintenance therapy following platinum-based induction in patients with advanced nonsquamous non-small cell lung cancer (NSCLC). The differences in the benefits of bevacizumab for treatment during early or late NSCLC have not yet been characterized. METHODS: We retrospectively analyzed data from 35 patients with advanced naïve NSCLC who had received pemetrexed/platinum with or without bevacizumab followed by maintenance therapy with pemetrexed alone or pemetrexed plus bevacizumab. The data were analyzed using the Kaplan-Meier method and Cox regression adjusted for risk factors. Patients were grouped according to treatment conditions. Group A received pemetrexed plus platinum followed by pemetrexed alone (Pem-Pt/Pem). Group B received pemetrexed plus platinum followed by pemetrexed and bevacizumab (Group B; Pem-Pt/Pem + Bev). Group C received pemetrexed, platinum, and bevacizumab during induction therapy, and pemetrexed as maintenance therapy (Group C; Pem-Pt + Bev/Pem + Bev). We assessed the significance of introduction of bevacizumab at different stages of treatment. RESULTS: A total of 13 (37.1%) patients were included in Group A, nine patients (25.7%) were included in Group B, and 13 patients (37.1%) were included in Group C. Among the 35 patients, 69.2% were male, and the median age was 59 years (range 40-75). The median progression-free survival (PFS) was 7.7 months (231 days, range 134-410 days) in Group A, 9.3 months (280 days, range 84-565 days) in Group B, and 8.0 months (241 days, range 108-665 days) in Group C. The median PFS was not significantly different among the three groups (P = 0.233). Similarly, bevacizumab did not significantly affect PFS (P = 0.630). CONCLUSIONS: The addition of bevacizumab into induction chemotherapy or maintenance therapy provided limited benefits to PFS in our study, but previous studies suggested that bevacizumab may improve disease control. In that way, we presume that early use of bevacizumab may provide a greater benefit.

Evaluation of efficacy and safety of gefitinib as monotherapy in Chinese patients with advanced non-small cell lung cancer and very poor performance status.

BACKGROUND: This paper reports the outcome of gefitinib for Chinese advanced NSCLC patients with poor performance status (PS) at the Peking Union Medical College Hospital. METHODS: From Oct 2002 to Apr. 2006, 42 advanced NSCLC patients with PS 3/4 received gefitinib 250 mg/day treatment. Median survival (MS) were calculated using the Kaplan-Meier method and a Cox regression model was used to find main factors affecting MS. RESULTS: Adverse events (AEs) were generally mild (grade 1 and 2) and reversible. The most frequent AEs were rash 72.2% (26/42) and diarrhea 44.4% (26/42). The objective tumor response rate and stable disease rate were 40.5% and 26.2% respectively, and median survival(MS) of all patients was 10.1 months (95% confidential interval CI, 3.4 ~ 16.8), and progression-free survival (PFS) was 5.7 months (95% CI, 4.5 ~ 6.9). The MS were significantly related with objective response of gefitinib. Objective responses was significantly related with rashes induced with gefitinib. CONCLUSION: Our study suggest that treatment with gefitinib may be well tolerated and beneficial for Chinese patients with poor PS, and the safety and efficacy were similar to patients with good PS.