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1.
In Vivo ; 36(3): 1333-1336, 2022.
Article in English | MEDLINE | ID: covidwho-1818960

ABSTRACT

BACKGROUND/AIM: COVID-19 vaccination is now performed in most of the world to limit the spread of the disease. The first mRNA vaccine was approved in clinical settings and has specific side effects including axillary lymph node swelling, which can be misdiagnosed as breast cancer metastasis. The timing of axillary lymph node swelling and its duration are unclear. Here, we present a Japanese case and review of the existing literature. CASE REPORT: We report the case of a 67-year-old woman with breast calcification. She had regular follow ups in our hospital for this calcification and received ultrasonography of the breast and axilla at every visit. She visited 6 months before having her COVID-19 vaccination, and 7 days and 6 months after the first COVID-19 vaccination. She had a swollen axillary lymph node 7 days after the first vaccination, which although it was improved, remained for 6 months. CONCLUSION: Axillary lymph node swelling occurred 7 days after vaccination and remained up to 6 months after it.


Subject(s)
Breast Neoplasms , COVID-19 , Neoplasms, Second Primary , Aged , Breast Neoplasms/pathology , COVID-19 Vaccines/adverse effects , Female , Humans , Japan , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Neoplasms, Second Primary/pathology , Vaccination/adverse effects , Vaccines, Synthetic
2.
Medicina (Kaunas) ; 58(4)2022 Apr 03.
Article in English | MEDLINE | ID: covidwho-1810018

ABSTRACT

Dabrafenib and trametinib are two available molecules that have been approved for the treatment of metastatic melanoma with BRAF-V600E or V600K mutations. Their combined therapy has led to long-lasting survival benefits and substantially improved outcomes. Until now, only a few cases of severe hypersensitivity reactions to dabrafenib and vemurafenib have been reported, and even fewer desensitization protocols to these molecules have been documented. We report the case of a 71-year-old female patient with metastatic melanoma harboring a BRAF-V600E mutation undergoing targeted therapy with dabrafenib and trametinib. Two weeks after the initiation of the combined treatment, she developed a hypersensitivity reaction. The cause-effect relationship between dabrafenib and the hypersensitivity reaction was demonstrated twice, when symptoms recurred upon dabrafenib reintroduction. We started a rapid 3-day dabrafenib desensitization protocol, which was well tolerated. When the patient discontinued the drug administration, we decided on a longer protocol that included more steps and more days in order to prevent the occurrence of other hypersensitivity reactions. Our patient tolerated both rapid and slow-going schedules, the first one reaching the final dose within 3 days and the second one reaching the total daily dose within 14 days. Depending on the patient's needs, the severity of the hypersensitivity reaction and the hospital's availability, the doctor may choose either the rapid or slow-going desensitization protocol.


Subject(s)
Melanoma , Neoplasms, Second Primary , Skin Neoplasms , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Female , Humans , Imidazoles , Melanoma/drug therapy , Melanoma/genetics , Mutation , Neoplasm Recurrence, Local/drug therapy , Neoplasms, Second Primary/etiology , Oximes , Proto-Oncogene Proteins B-raf/genetics , Skin Neoplasms/pathology
3.
Br J Nurs ; 31(8): 414-420, 2022 Apr 21.
Article in English | MEDLINE | ID: covidwho-1791705

ABSTRACT

This article discusses the implementation and development of a centralised immuno-oncology service. As the indications and licensing of oncological immune checkpoint inhibitors (ICIs) expanded rapidly, they brought with them increasing challenges. The article evaluates the impact of an immuno-oncology service, focusing on the following areas: admission rates due to immune-related adverse events (irAEs), number of bed days occupied due to immunotherapy toxicity and the incidence of Grade 3 and 4 (severe and life-threatening) irAEs. The article will also give an overview of patients requiring acute and subsequent management of toxicity as a percentage of the overall patients commenced on immunotherapy. The ultimate aim of the article is to highlight the importance of toxicity management and the overall benefits of a immuno-oncology service. The article will also discuss the impact of COVID-19 on the immuno-oncology service, highlighting the ways in which the team has adapted to the current environment to ensure high standards of patient care have been maintained.


Subject(s)
COVID-19 , Neoplasms, Second Primary , Neoplasms , Humans , Immunotherapy/adverse effects , Medical Oncology , Neoplasms/etiology , Neoplasms/therapy , Neoplasms, Second Primary/etiology , United Kingdom
4.
Dermatol Online J ; 27(12)2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1789589

ABSTRACT

Myxofibrosarcoma frequently recurs locally but rarely metastasizes. Herein, we describe an elderly woman who had myxofibrosarcoma of the right elbow that went untreated during the COVID-19 pandemic. She subsequently presented with two large tumors ulcerating through the skin of her right elbow and left hip.


Subject(s)
COVID-19 , Fibrosarcoma , Histiocytoma, Malignant Fibrous , Neoplasms, Second Primary , Aged , Elbow , Female , Fibrosarcoma/diagnosis , Histiocytoma, Malignant Fibrous/diagnosis , Humans , Pandemics
5.
J Natl Cancer Inst ; 114(4): 571-578, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1566036

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led to delays in patients seeking care for life-threatening conditions; however, its impact on treatment patterns for patients with metastatic cancer is unknown. We assessed the COVID-19 pandemic's impact on time to treatment initiation (TTI) and treatment selection for patients newly diagnosed with metastatic solid cancer. METHODS: We used an electronic health record-derived longitudinal database curated via technology-enabled abstraction to identify 14 136 US patients newly diagnosed with de novo or recurrent metastatic solid cancer between January 1 and July 31 in 2019 or 2020. Patients received care at approximately 280 predominantly community-based oncology practices. Controlled interrupted time series analyses assessed the impact of the COVID-19 pandemic period (April-July 2020) on TTI, defined as the number of days from metastatic diagnosis to receipt of first-line systemic therapy, and use of myelosuppressive therapy. RESULTS: The adjusted probability of treatment within 30 days of diagnosis was similar across periods (January-March 2019 = 41.7%, 95% confidence interval [CI] = 32.2% to 51.1%; April-July 2019 = 42.6%, 95% CI = 32.4% to 52.7%; January-March 2020 = 44.5%, 95% CI = 30.4% to 58.6%; April-July 2020 = 46.8%, 95% CI= 34.6% to 59.0%; adjusted percentage-point difference-in-differences = 1.4%, 95% CI = -2.7% to 5.5%). Among 5962 patients who received first-line systemic therapy, there was no association between the pandemic period and use of myelosuppressive therapy (adjusted percentage-point difference-in-differences = 1.6%, 95% CI = -2.6% to 5.8%). There was no meaningful effect modification by cancer type, race, or age. CONCLUSIONS: Despite known pandemic-related delays in surveillance and diagnosis, the COVID-19 pandemic did not affect TTI or treatment selection for patients with metastatic solid cancers.


Subject(s)
COVID-19 , Neoplasms, Second Primary , COVID-19/epidemiology , Humans , Neoplasm Recurrence, Local/epidemiology , Neoplasms, Second Primary/epidemiology , Pandemics , Time-to-Treatment , United States/epidemiology
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