Abstract | INTRODUCTION: CASE DESCRIPTION: We present a case of a 41 years old man, non-smoker for the last 5 years, who was diagnosed with a pneumonic form of nonmucinous bronchioloalveolar carcinoma. Metastases to regional and distant lymph nodes and massive involvement of skeleton with infiltrations in the bone marrow were present at the diagnosis. During the first line palliative chemotherapy with combination regimen of carboplatin and paclitaxel, the disease progressed significantly and the patient's condition deteriorated (performance status (PS) 3, severe dyspnoea at rest, malignant bronchorrhea). Subsequently, administration of erlotinib was initiated based on a series of case studies describing good response of BAC to treatment with EGFR TKI. An evident improvement of the patient's condition was observed as early as 4 days of administration, together with regression of peripheral lymphadenopathy. Nearly complete disappearance of pulmonary infiltrates was observed after 30 days of therapy, with the patient becoming asymptomatic, PS 0. Molecular genetics confirmed the tumour phenotype to be highly responsive to EGFR TKI therapy. The tumour contained EGFR mutation in exon 19 (in-frame L747-753insS deletion) and wild-type K-ras. Disease relapse in the liver occurred 6 months later confirming disease progression. Further treatment remained ineffective despite brief stabilisations of liver enzyme progression following repeated administration of pemetrexed and gefitinib. The patient died 12 months after the diagnosis. CONCLUSIONS: Our case confirms the importance of targeted therapy when treating tumours of an appropriate phenotype. Such treatment may have prompt and intensive effect that may reverse the course of the disease even in patients with poor overall health status.
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Authors | M Svoboda, P Fabian, O Slabý, M Stanková, R Lakomý, R Nemecek, R Vyzula |
Journal | Klinicka onkologie : casopis Ceske a Slovenske onkologicke spolecnosti
(Klin Onkol)
Vol. 23
Issue 4
Pg. 224-30
( 2010)
ISSN: 0862-495X [Print] Czech Republic |
Vernacular Title | Cílená lécba bronchioloalveolárního plicního adenokarcinomu inhibitory tyrozinkinázové aktivity EGFR: kazuistika klinicky promptní a výrazné odpovedi a prehled literatury. |
PMID | 20806820
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
- Protein Kinase Inhibitors
- Quinazolines
- Erlotinib Hydrochloride
- ErbB Receptors
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Topics |
- Adenocarcinoma, Bronchiolo-Alveolar
(drug therapy)
- Adult
- ErbB Receptors
(antagonists & inhibitors)
- Erlotinib Hydrochloride
- Humans
- Lung Neoplasms
(drug therapy)
- Male
- Protein Kinase Inhibitors
(therapeutic use)
- Quinazolines
(therapeutic use)
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