RESUMO
INTRODUCTION: Pegylated irinotecan NKTR-102 is a topoisomerase I inhibitor-polymer conjugate. This new formulation of irinotecan has been evaluated in a phase II clinical trial and is showing remarkable activity. To the best of our knowledge, this is the first case report of an impressive iterative response to pegylated irinotecan NKTR-102 in metastatic breast cancer. CASE PRESENTATION: We report the case of a 49-year-old Caucasian woman diagnosed with metastatic luminal A breast cancer with initial bone followed by liver and bone marrow metastases, treated with three lines of hormonal therapy, targeted therapy and six lines of chemotherapy. She showed no major response to conventional treatment, whereas, the tumor shrinkage under pegylated irinotecan NKTR-102 was impressive, durable and iterative. CONCLUSIONS: Reintroduction of an active drug is a valid approach as illustrated by our case. The results of the current phase III trials of pegylated irinotecan NKTR-102 are eagerly awaited.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Camptotecina/análogos & derivados , Camptotecina/uso terapêutico , Feminino , Humanos , Irinotecano , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Indução de Remissão , Inibidores da Topoisomerase I/uso terapêuticoAssuntos
Linfoma/patologia , Neoplasias da Bexiga Urinária/patologia , Anticorpos Monoclonais Murinos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Humanos , Linfoma/diagnóstico por imagem , Linfoma/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Indução de Remissão , Rituximab , Ultrassonografia , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/tratamento farmacológico , Vincristina/uso terapêuticoRESUMO
Despite many treatment advances, metastatic breast cancer remains an incurable disease and is the third leading cause of cancer-related deaths in Europe. Capecitabine has become a standard treatment option for metastatic breast cancer, as a single agent or in combination. Hand-foot syndrome and diarrhoea are the most frequently reported side effects, while capecitabine-related ileitis is very rare. Deficiency of dihydropyrimidine dehydrogenase activity leads to severe toxicities after administration of 5-fluorouracil or its prodrugs. We report two cases of patients with metastatic breast cancer who developed ileitis after treatment with capecitabine. One patient had a DPYD gene abnormality.
Assuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Desoxicitidina/análogos & derivados , Di-Hidrouracila Desidrogenase (NADP)/genética , Fluoruracila/análogos & derivados , Ileíte/induzido quimicamente , Mutação , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Capecitabina , Carcinoma Ductal/tratamento farmacológico , Carcinoma Ductal/genética , Carcinoma Ductal/patologia , Colite/diagnóstico , Contraindicações , Desoxicitidina/efeitos adversos , Diagnóstico Diferencial , Diarreia/induzido quimicamente , Diarreia/diagnóstico , Deficiência da Di-Hidropirimidina Desidrogenase/complicações , Feminino , Fluoruracila/efeitos adversos , Humanos , Metástase Neoplásica , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/patologiaRESUMO
INTRODUCTION: Primary renal Ewing sarcoma/PNET is an uncommon and very aggressive tumor. PRESENTATION OF CASE: : We report the case of a young woman who underwent nephrectomy for a renal mass from unknown etiology. Histologic analysis found small tumoral cells in rosette formation, and immunohistochemical staining was positive for CD99, and focally positive for vimentin and Protein S-100. A post operative abdominal computed tomography (CT) scan revealed a residual renal processus with hepatic wounds and abdominal metastatic nodes. After 6 cycles of chemotherapy including Vincristine, Doxorubicin, Cyclophosphamide, the response was considered as good. DISCUSSION: Ewing's sarcoma/PNET of kidney is a member of the family of small round cell tumors and it should be differentiated from Wilms tumor, neuroblastoma, rhabdomyosarcoma and lymphoblastic lymphoma. The principle management of its treatment have been extrapolated from the treatment of osseous Ewing sarcoma of bone. CONCLUSION: Despite aggressive treatment, primary renal Ewing sarcoma/PNET has a poor prognosis. It requires a multidisciplinary approach including oncologists, urologists and radiation oncologists.