ABSTRACT
INTRODUCTION: RFC is the major transport system in mammalian cells for folate cofactors and antifolate therapeutics. The aim of this study was to assess the predictive value of RFC expression in patients receiving pemetrexed for advanced NSCLC. METHODS: The study was carried out in a population of 48 patients with advanced NSCLC which have received pemetrexed monotherapy in second and third line. RFC expression was assessed using a two-step model of immunohistochemical staining in paraffin-embedded tissue samples. RESULTS: RFC expression was detected in 16 (33 %) patients. In the global population, the median progression free survival (PFS) and the median overall survival (OS) were 3.3 and 6.5 months respectively. The subgroup of patients with expression of RFC had a tendency to better median PFS (4.5 vs 2.8 months; p = 0.926) and median OS (11.7 vs 4.8; p = 0.150). In patients with adenocarcinoma histology and RFC expression median OS after treatment with pemetrexed was 14.4 months versus 5.0 in those with adenocarcinoma but without RFC expression (p = 0.039). CONCLUSIONS: These results suggest the possible relation between RFC expression and response to treatment with antifolates (pemetrexed) independently of the tumor histology. Further studies are required to confirm these results.
Subject(s)
Antineoplastic Agents/therapeutic use , Biomarkers, Tumor/metabolism , Carcinoma, Non-Small-Cell Lung/drug therapy , Glutamates/therapeutic use , Guanine/analogs & derivatives , Lung Neoplasms/drug therapy , Reduced Folate Carrier Protein/metabolism , Adult , Aged , Antineoplastic Agents/pharmacology , Carcinoma, Non-Small-Cell Lung/metabolism , Female , Glutamates/pharmacology , Guanine/pharmacology , Guanine/therapeutic use , Humans , Lung Neoplasms/metabolism , Male , Middle Aged , Pemetrexed , Thymidylate Synthase/antagonists & inhibitorsABSTRACT
Benign recurrent intrahepatic cholestasis (BRIC) is a rare form of intrahepatic cholestasis characterized by repeated self-limited episodes of severe pruritus and jaundice. Classically its natural evolution is benign, without progress to fibrosis or hepatic insufficiency; although, lastly were reported cases which progress to Progressive familial intrahepatic cholestasis (PFIC). This disease is characterized by progressive hepatic insufficiency and cirrhosis. We present the case of a 32 years old male patient who went to Gastroenterology Service of Arzobispo Loayza National Hospital by pruritus and jaundice. We reported this case for its infrequent presentation and because is an entity which should be considered within differential diagnosis of hepatic cholestasis diseases.
Subject(s)
Cholestasis, Intrahepatic/diagnosis , Adult , Cholestasis, Intrahepatic/genetics , Disease Progression , Humans , Male , RecurrenceABSTRACT
La Colestasis Intrahepatica Benigna Recurrente (CIBR) es una rara forma de colestasis intrahepatica caracterizada por episodios recurrentes y autolimitados de ictericia y prurito intensos. Clásicamente su evolución natural es benigna, sin progresión a fibrosis o insuficiencia hepática; sin embargo, últimamente se han reportado casos que progresan a Colestasis Intrahepatica Familiar Progresiva (CIFP), ésta última caracterizada porinsuficiencia hepática y cirrosis. Presentamos el caso de un paciente varón de 32 años que acude al Servicio de Gastroenterología del Hospital Nacional "Arzobispo Loayza",por ictericia y prurito. Lo reportamos por lo infrecuente de su presentación y por ser una entidad que debemos tener en cuenta en el diagnóstico diferencial de enfermedades hepáticas colestásicas.
Benign recurrent intrahepatic cholestasis (BRIC) is a rare form of intrahepatic cholestasischaracterized by repeated self-limited episodes of severe pruritus and jaundice. Classicallyits natural evolution is benign, without progress to fibrosis or hepatic insufficiency; although,lastly were reported cases which progress to Progressive familial intrahepatic cholestasis(PFIC). This disease is characterized by progressive hepatic insufficiency and cirrhosis.We present the case of a 32 years old male patient who went to Gastroenterology Serviceof Arzobispo Loayza National Hospital by pruritus and jaundice. We reported this case forits infrequent presentation and because is an entity which should be considered withindifferential diagnosis of hepatic cholestasis diseases.
