ABSTRACT
BACKGROUND/AIMS@#This study was to evaluate the clinical significance of infusion-related reaction (IRR) of rituximab in diffuse large B-cell lymphoma (DLBCL) patients who received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) as a first-line chemotherapy.@*METHODS@#The medical records of 326 patients diagnosed with DLBCL were re trospectively analyzed. Both doctor's progress records and nursing records were reviewed. IRR was graded according to the National Cancer Institute Common Terminology Criteria.@*RESULTS@#IRR was not associated with overall survival (OS) or progression-free survival (PFS) of DLBCL patients as compared to those who did not have IRR (OS: median 78.0 months vs. 69.0 months, p = 0.700; PFS: median 65.4 months vs. 64.0 months, p = 0.901). IRR grade did not affect OS or PFS. B symptoms was independently associated with IRR (hazard ratio [HR], 1.850; 95% confidence interval [CI], 1.041 to 3.290; p = 0.036). Further, bone marrow involvement was independently associated with re-IRR (HR, 4.904; 95% CI, 0.767 to 3.118; p = 0.029).@*CONCLUSIONS@#Our study shows that IRR of rituximab is not associated with OS or PFS of DLBCL patients who received R-CHOP. Furthermore, our study suggests a need for more careful observation for IRR in patients with B symptoms or bone marrow involvement.
ABSTRACT
BACKGROUND/AIMS: The purpose of this study was to identify predictive factors for erlotinib treatment in non-small cell lung cancer (NSCLC) patients following gefitinib failure. METHODS: Forty-five patients with NSCLC who were treated with erlotinib following gefitinib failure at Seoul National University Hospital between August 2005 and November 2011 were enrolled. Epidermal growth factor receptor (EGFR) mutation status, pathologic findings and other clinical factors, including response to tyrosine kinase inhibitors (TKIs) and progression-free survival (PFS), were evaluated. RESULTS: Of the 45 patients, 40 patients (88.8%) had adenocarcinoma. The following EGFR mutations were observed: five patients with a deletion of exon 19, six patients with an L858R mutation, three patients with wild-type EGFR, and 31 patients with unknown mutations. The response rate of erlotinib was 4.4%, and stable disease was 42.2%. The median PFS for erlotinib was 2.6 months (95% confidence interval, 1.4 to 3.7). Patients with a PFS > or = 4 months during previous gefitinib treatment had a significantly longer PFS with erlotinib (3.3 months vs. 1.6 months, respectively; p or = 4 months for previous gefitinib treatment was significantly associated with prolonged PFS with erlotinib (p = 0.04). However, the response rate of gefitinib and treatment sequence were not associated with prolonged PFS with erlotinib (p = 0.28 and p = 0.67, respectively). CONCLUSIONS: Following rechallenge with the EGFR TKI erlotinib following gefitinib failure, patients who showed prolonged PFS with gefitinib benefit from erlotinib. However, further prospective studies are needed to confirm these findings.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antineoplastic Agents/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Chi-Square Distribution , Disease-Free Survival , Erlotinib Hydrochloride/therapeutic use , Hospitals, University , Kaplan-Meier Estimate , Lung Neoplasms/drug therapy , Multivariate Analysis , Mutation , Proportional Hazards Models , Protein Kinase Inhibitors/therapeutic use , Quinazolines/therapeutic use , ErbB Receptors/antagonists & inhibitors , Republic of Korea , Retrospective Studies , Risk Factors , Salvage Therapy , Time Factors , Treatment FailureABSTRACT
We report here on a rare case of membranous nephropathy occurring concurrently with salivary gland cancer. A 67-year-old woman was admitted to our department for nephrotic syndrome. She was diagnosed with membranous nephropathy and this was initially managed with steroids and cyclophosphamide, which started in 2003 and continued for about 10 months, without deriving any therapeutic benefits. During the treatment, the patient was diagnosed with salivary gland cancer when an incidental salivary gland mass was discovered in 2005. The patient's urinary protein level began to decrease following resection of the malignant mass. The clinical findings represent an interesting case of secondary membranous nephropathy that was diagnosed prior to the incidental discovery of malignancy.