Synergistic Occurrence of EGFR, ALK, and KRAS Gene Mutations in a Patient with Non-small Cell Lung Cancer (Adenocarcinoma)

Lung cancer is a commonly diagnosed malignancy. Adenocarcinoma, a subgroup of non-small cell lung cancer, is the commonest form and presents in an advanced stage of the disease, leaving a limited treatment option. Response to the standard chemotherapy regimens is overall poor. We present a case of synergistic occurrence of triple gene mutations in a patient with well-diff erentiated adenocarcinoma lung treated at a tertiary cancer care center in North India.

Case Report of Non-small Cell Lung Cancer Patient with EGFR T790M Mutation Treated with Th ird Generation Inhibitor

Lung cancer treatment based on the molecular classifi cation of the tumor has paved the way for multiple lines of targeted treatment, even though the development of resistance remains a major cause of concern. Epidermal growth factor receptor (EGFR) remains the poster boy for the use of targeted therapy, and the presence/absence of mutations in this gene has led to the development of inhibitors targeting specifi c mutations. We present the case of an advanced non-small cell lung cancer patient with EGFR T790M mutation treated with Osimertinib, a third-generation inhibitor.

Primary testicular non-Hodgkin's lymphoma: a review article

Primary testicular non-Hodgkin's lymphoma was first described as a clinical entity in 1866. It is a rare disease and accounts for 1 percent of all non-Hodgkin's lymphoma, 2 percent of all extranodal lymphomas and 5 percent of all testicular neoplasms. It is the most common testicular tumor in males between sixty and eighty years of age. Testicular non-Hodgkin's lymphoma is unique in its high incidence of bilateral involvement (8-38 percent), and it is also the most common bilateral testicular tumor. Testicular non-Hodgkin's lymphoma has a predilection for spreading to non-contiguous extranodal sites, especially the central nervous system. Advanced-stage disease is usually managed with doxorubicin-based chemotherapy. For early-stage disease, opinion is divided regarding systemic chemotherapy following orchidectomy. The high incidence of spreading, especially to the central nervous system, leads to advocacy of the use of central nervous system prophylaxis with intrathecal chemotherapy. Prospective multicenter trials incorporating a large number of patients may lead to better guidelines for optimal management of this subtype of non-Hodgkin's lymphoma.

O linfoma primário do testículo (LPT) foi descrito como uma entidade clínica pela primeira vez em 1866. É uma doença rara e corresponde a 1 por cento de todos os linfomas não-Hodgkin, 2 por cento de todos os linfomas extranodais e 5 por cento de todos as neoplasias testiculares. É o tumor testicular mais comum em homens entre 60 e 80 anos de idade. LPT é único em sua elevada incidência de envolvimento bilateral (8-38 por cento), sendo o tumor testicular bilateral mais comum. Tem uma predileção por disseminação para regiões extranodais não-contíguas, especialmente para o sistema nervoso central (SNC). Estágios avançados da doença são usualmente tratados com quimioterapia à base de doxorubicina. Para os estágios mais precoces, as opiniões são divergentes quanto à quimioterapia associada à orquiectomia. A alta prevalência de disseminação, especialmente para o SNC, sugere o uso de quimioterapia intratecal como profilaxia. Estudos prospectivos multicêntricos incluindo um grande número de pacientes poderiam resolver a questão com relação ao manejo deste subtipo de linfoma não-Hodgkin.