RESUMO
When molecular target drug began to be used for chemotherapy to treat malignant pleural mesothelioma in 2014, we introduced this treatment strategy for 61 patients who were diagnosed and were being treated in our hospital. Chemotherapy was performed on 37 patients, while 12 patients underwent surgical remedy and best supportive care was provided to another 12 patients. Molecular target drug was used as the primary chemotherapy treatment in 14 cases, while it was the secondary treatment in 22 others. Pleural decortication was performed as the operative method for all the 12 cases requiring surgical remedy, and 2 of these cases were shifted to extrapleural pneumonectomy. By the chemotherapy, there were many cases of PS≥2, nonâepithelial type, advanced stage, LMR<2.74 of the biomarker. When we compared surgical remedy with the chemotherapy clinicopathologically. In the prognostic examination, in median survival time of all cases, as for 23 months, the chemotherapy, 31 months, the surgical remedy was not reached. Prognostic improvement of stage â ¢A was determined according to the stage of the chemotherapy. A multivariate variable analysis revealed that only a nonâsarcomatous type was a good prognostic factor, and surgery remedy was not.
Assuntos
Mesotelioma Maligno , Mesotelioma , Neoplasias Pleurais , Hospitais , Humanos , Mesotelioma/tratamento farmacológico , Mesotelioma/cirurgia , Neoplasias Pleurais/tratamento farmacológico , Neoplasias Pleurais/cirurgia , Pneumonectomia , Resultado do TratamentoRESUMO
A 72-year-old male with gastric cancer was referred to our hospital. The patient had been administered warfarin for cerebral infarction, aspirin and clopidogrel sulfate after percutaneous coronary intervention (PCI). Distal gastrectomy was performed for the lesion after discontinuing these drugs. After operation, warfarin was administered again as soon as possible, and on the other hand, we started treating the patient with S-1 for adjuvant chemotherapy carefully, because the interaction of each drug had been described before. On the sixth day after starting S-1, we reduced the amount of warfarin because PT-INR was elevated to a extremely high level of 6.84. Seven days later, PT-INR recovered to a slightly high level of 2.17. With continuation of S-1, PT-INR showed large fluctuations, so we needed to regulate the amount of warfarin carefully. It is important that we recognize the possibility of immediate interaction of two drugs and, before these drugs are administered, inform the patient about it.
Assuntos
Anticoagulantes/administração & dosagem , Antimetabólitos Antineoplásicos/administração & dosagem , Ácido Oxônico/administração & dosagem , Neoplasias Gástricas/tratamento farmacológico , Tegafur/administração & dosagem , Varfarina/administração & dosagem , Idoso , Anticoagulantes/efeitos adversos , Antimetabólitos Antineoplásicos/efeitos adversos , Infarto Cerebral/tratamento farmacológico , Quimioterapia Adjuvante/efeitos adversos , Combinação de Medicamentos , Gastrectomia , Humanos , Masculino , Ácido Oxônico/efeitos adversos , Tegafur/efeitos adversos , Varfarina/efeitos adversosRESUMO
Clinical benefits of cetuximab retreatment in patients with metastatic colorectal (mCRC) have been reported. In the present study, the effect of cetuximab retreatment on predictive markers was investigated by evaluating the clinical benefit of initial cetuximab treatment prior to cetuximab retreatment. Between November 2012 and March 2017, 14 patients with KRAS proto-oncogene GTPase exon 2 wild-type mCRC who exhibited a clinical benefit (confirmed stable disease for at least 6 months or a clinical response) to an initial cetuximab-based regimen, who received multiple lines of chemotherapy following disease progression and ultimately received a second cetuximab and irinotecan regimen, were retrospectively analyzed. For retreatment, patients received bi-weekly irinotecan (120-150 mg/m2) combined with cetuximab (400 mg/m2 as an initial dose, followed by 250 mg/m2, weekly). The median age of the 14 patients (11 males, 3 females) was 68 years (32-77). The median progression-free survival (PFS) following prior cetuximab-based therapy was 6.6 months (range, 4.1-18.4). Initial cetuximab treatment was administered as a first-line treatment in 11 patients, a second-line treatment in 1 patient and a third-line treatment in 2 patients. The median interval time between the last cycle of initial cetuximab-based therapy and the first cycle of cetuximab retreatment was 13.1 months (range, 6.0-37.1). The objective response rate of cetuximab retreatment was 21.4% and the median PFS was 4.4 months (95% confidence interval, 1.4-5.6). The Spearman's correlation coefficient for the PFS following retreatment and duration of initial cetuximab-based regimens demonstrated a more marked correlation compared with that between the PFS following retreatment and the interval time between the two regimens (r=0.45, P=0.11 vs. r=0.08, P=0.79). Cetuximab retreatment may provide clinical benefit to patients with mCRC who were good responders with longer periods of initial cetuximab-based therapy.