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[PMID]:28790264
[Au] Autor:Tanaka H; Inomata M; Hayashi R; Shimokawa K; Tokui K; Okazawa S; Kambara K; Yamada T; Miwa T; Kashii T; Konishi H; Tobe K
[Ad] Endereço:First Dept. of Internal Medicine, Toyama University Hospital.
[Ti] Título:[A Case of Lung Adenocarcinoma Presenting with Leptomeningeal Carcinomatosis Successfully Treated with Afatinib after Erlotinib-Induced Hepatotoxicity].
[So] Source:Gan To Kagaku Ryoho;44(7):595-597, 2017 Jul.
[Is] ISSN:0385-0684
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 65-year-old man was diagnosed with leptomeningeal carcinomatosis based on the findings of cerebrospinal fluid cytology and magnetic resonance imaging(MRI).Treatment with erlotinib and bevacizumab was initiated, and partial improvement in consciousness and MRI findings were obtained.However, it was difficult to continue the treatment because of elevation in levels of liver enzymes and melena.We switched the treatment to afatinib monotherapy, and his consciousness improved immediately.Progression -free survival and overall survival from the initiation of the treatment with afatinib were 7 and 9.4 months, respectively. This clinical course suggests activity of afatinib for central nervous system lesions of EGFRmutated lung cancer.
[Mh] Termos MeSH primário: Adenocarcinoma/tratamento farmacológico
Antineoplásicos/efeitos adversos
Doença Hepática Induzida por Substâncias e Drogas
Cloridrato de Erlotinib/efeitos adversos
Neoplasias Pulmonares/tratamento farmacológico
Carcinomatose Meníngea/tratamento farmacológico
Quinazolinas/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Antineoplásicos/uso terapêutico
Cloridrato de Erlotinib/uso terapêutico
Seres Humanos
Masculino
Carcinomatose Meníngea/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Quinazolines); 41UD74L59M (afatinib); DA87705X9K (Erlotinib Hydrochloride)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE


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[PMID]:28739703
[Au] Autor:Tamiya A; Tamiya M; Nishihara T; Shiroyama T; Nakao K; Tsuji T; Takeuchi N; Isa SI; Omachi N; Okamoto N; Suzuki H; Okishio K; Iwazaki A; Imai K; Hirashima T; Atagi S
[Ad] Endereço:National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan atamiya@kch.hosp.go.jp.
[Ti] Título:Cerebrospinal Fluid Penetration Rate and Efficacy of Afatinib in Patients with EGFR Mutation-positive Non-small Cell Lung Cancer with Leptomeningeal Carcinomatosis: A Multicenter Prospective Study.
[So] Source:Anticancer Res;37(8):4177-4182, 2017 08.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Afatinib is an effective first-line treatment for epidermal growth factor receptor (EGFR) mutation-positive advanced non-small cell lung cancer (NSCLC). However, few reports have addressed the influence of cerebrospinal fluid (CSF) penetration rate on the efficacy of afatinib in patients with central nervous system metastases. Therefore, we conducted a prospective multicenter trial to evaluate the CSF penetration rate and efficacy of afatinib in patients with EGFR mutation-positive NSCLC with leptomeningeal carcinomatosis. PATIENTS AND METHODS: Eleven patients with histologically-proven EGFR mutation-positive NSCLC with leptomeningeal carcinomatosis were enrolled in the study between April 2014 and November 2015. They were treated with afatinib (40 mg/day), and blood and CSF levels of afatinib were analyzed on day 8. The primary endpoint was CSF penetration rate. Secondary endpoints included the objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). RESULTS: The median age of patients was 66 years. Five patients harbored an exon 19 deletion, three harbored a p.L858R point mutation, and three harbored an uncommon exon 18 mutation. The levels of afatinib in blood and CSF (mean±SD) were 233.26±195.40 nM and 3.16±1.95 nM, respectively. The CSF penetration rate was 2.45±2.91%. The ORR was 27.3% (three out of 11 patients), and two out of these three responders had uncommon EGFR mutations. The median PFS and OS were 2.0 and 3.8 months, respectively. CONCLUSION: The median CSF penetration rate of afatinib was higher than previously reported. Afatinib was effective against leptomeningeal carcinomatosis particularly in patients with NSCLC harboring uncommon EGFR mutations. The criteria for selecting a specific EGFR tyrosine kinase inhibitor for therapy of NSCLC should include its ability to penetrate CSF and its efficacy against specific mutation types.
[Mh] Termos MeSH primário: Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico
Carcinomatose Meníngea/tratamento farmacológico
Quinazolinas/administração & dosagem
Receptor do Fator de Crescimento Epidérmico/genética
[Mh] Termos MeSH secundário: Idoso
Carcinoma Pulmonar de Células não Pequenas/líquido cefalorraquidiano
Carcinoma Pulmonar de Células não Pequenas/genética
Carcinoma Pulmonar de Células não Pequenas/patologia
Intervalo Livre de Doença
Éxons/genética
Feminino
Seres Humanos
Masculino
Carcinomatose Meníngea/líquido cefalorraquidiano
Carcinomatose Meníngea/genética
Carcinomatose Meníngea/patologia
Meia-Idade
Mutação
Inibidores de Proteínas Quinases/administração & dosagem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Protein Kinase Inhibitors); 0 (Quinazolines); 41UD74L59M (afatinib); EC 2.7.10.1 (EGFR protein, human); EC 2.7.10.1 (Receptor, Epidermal Growth Factor)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE


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[PMID]:28379128
[Au] Autor:Warley F; Bonella MB; Giunta DH; Elizondo CM; Ferreyro BL
[Ad] Endereço:Departamento de Medicina Interna, Hospital Italiano de Buenos Aires. Área de Investigación en Medicina Interna, departamento de Medicina Interna, Hospital Italiano de Buenos Aires.
[Ti] Título:[Associated factors with the presence of secondary neoplastic cells in the cerebrospinal fluid of patients with suspected carcinomatous meningitis].
[Ti] Título:Factores asociados a presencia de células neoplásicas secundarias en el liquido cefalorraquideo de pacientescon sospecha de meningitis carcinomatosa..
[So] Source:Rev Fac Cien Med Univ Nac Cordoba;74(1):26-32, 2017.
[Is] ISSN:1853-0605
[Cp] País de publicação:Argentina
[La] Idioma:spa
[Ab] Resumo:BACKGROUND: Improvement in oncologic therapy has increased survival in oncologic patients. There has been a concomitant increase in the incidence of secondary meningeal involvement. Early diagnosis is mandatory. OBJECTIVE: To identify factors associated with the presence of secondary neoplastic cells in cerebrospinal fluid of patients with suspected carcinomatous meningitis (CM) Methods: Cross-sectional study involving adult patients with solid cancer diagnosis and suspected CM between 2004 and 2014 at Hospital Italiano de Buenos Aires. All included patients had at least one lumbar puncture with cerebrospinal fluid (CSF) analysis. CM cases were defined by the presence of neoplastic cells in CFS. We evaluated the association of each factor (cancer characteristics, clinical engagement of central nervous system, CSF analysis) with CM using a logistic regression model. RESULTS: We included 77 patients: mean age was 62 years (SD 13.1), 58.4% (45) were female. The most common oncologic disease was lung cancer 29.9% (23), followed by breast 23.4% (18) cancer. CM was detected in 23.4% (18) patients. In univariate analysis, glychorrachia, the CSF leukocyte count, the meningeal involvement on MRI, headache and delirium were significantly associated with MC. In the multivariate model that included the variables significantly associated in the crude analysis, the only variable that remained significantly associated with MC was the glychorrachia (OR 0.93 95%CI 0.9 - 0.97, p <0.001). DISCUSSION: These results suggest that as the glychorrachia increases, the probability of having MC decreases. These findings are consistent with previous studies.
[Mh] Termos MeSH primário: Líquido Cefalorraquidiano/citologia
Carcinomatose Meníngea/líquido cefalorraquidiano
[Mh] Termos MeSH secundário: Estudos Transversais
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Carcinomatose Meníngea/secundário
Meia-Idade
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170725
[Lr] Data última revisão:
170725
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE


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[PMID]:28242865
[Au] Autor:Maur M; Omarini C; Piacentini F; Fontana A; Pettorelli E; Cascinu S
[Ad] Endereço:Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy.
[Ti] Título:Metronomic Capecitabine Effectively Blocks Leptomeningeal Carcinomatosis From Breast Cancer: A Case Report and Literature Review.
[So] Source:Am J Case Rep;18:208-211, 2017 Feb 28.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Meningeal carcinomatosis is a rare complication in breast cancer patients. At present, there are no defined guidelines for its management. The efficacy of systemic treatment seems to depend on its ability to cross the blood-brain-barrier and its interaction with tumor vasculature. Metronomic chemotherapy is a known modality of drug administration able to inhibit tumor angiogenesis. CASE REPORT We present a case of symptomatic leptomeningeal carcinomatosis from breast cancer successfully treated with capecitabine. Based on the hypothesis that angiogenesis contributes to neoplastic meningitis, the patient was treated with a metronomic schedule that provided long-term clinical benefit with a very low toxicity profile. CONCLUSIONS To assess the real impact of metronomic chemotherapy in patients with meninges involvement, a phase II study will be starting soon in our institution. A review of the literature concerning the management of meningeal carcinomatosis is also presented.
[Mh] Termos MeSH primário: Antimetabólitos Antineoplásicos/administração & dosagem
Neoplasias da Mama/tratamento farmacológico
Neoplasias da Mama/patologia
Capecitabina/administração & dosagem
Carcinomatose Meníngea/tratamento farmacológico
Carcinomatose Meníngea/secundário
Neoplasias Meníngeas/tratamento farmacológico
Neoplasias Meníngeas/secundário
[Mh] Termos MeSH secundário: Administração Metronômica
Neoplasias da Mama/complicações
Feminino
Seres Humanos
Carcinomatose Meníngea/complicações
Neoplasias Meníngeas/complicações
Meia-Idade
Convulsões/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antimetabolites, Antineoplastic); 6804DJ8Z9U (Capecitabine)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170320
[Lr] Data última revisão:
170320
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE


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[PMID]:28231581
[Au] Autor:Alnajar H; Rosen L; Javidiparsijani S; Al-Ghamdi Y; Gattuso P
[Ad] Endereço:Department of Pathology, Rush University Medical Center, Chicago, IL, USA.
[Ti] Título:Prognostic Markers and Histologic Subtypes in Patients with Meningeal Carcinomatosis in Breast Cancer.
[So] Source:Acta Cytol;61(2):140-144, 2017.
[Is] ISSN:1938-2650
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Meningeal carcinomatosis (MC) is a rare complication in breast cancer patients. It is defined as a diffuse or multifocal leptomeningeal metastasis. STUDY DESIGN: From our institution database, we retrospectively studied 19 patients diagnosed with MC in the cerebrospinal fluid (CSF) in 1997-2015, in order to evaluate tumor prognostic markers, histologic subtypes, and clinical outcome. RESULTS: All patients were female, with a mean age of 53 years (range 36-75 years). The mean interval between diagnosis of breast carcinoma and MC was 28 months (range 6-62 months). The median survival from the time of diagnosis was 2 months (1-51 months). Sixteen cases (84%) were the ductal phenotype, 62% of which were of a high grade (grade 3), and 3 cases (16%) were lobular. Estrogen and progesterone receptors were positive on immunohistochemistry (IHC) in 53 and 33% of patients, respectively. HER2 IHC was positive (3+) in 20% of the cases; all were amplified by fluorescence in situ hybridization. The incidence of MC in triple-negative tumors was 40%. Twelve patients (63%) already had known metastasis at the time of diagnosis. CONCLUSIONS: Most cases of MC are high-grade ductal. MC is more common in triple-negative breast cancers. The outcome of these breast cancer patients with MC was poor. There was no survival difference according to age, histologic subtype, grade, or hormonal or HER2 status.
[Mh] Termos MeSH primário: Biomarcadores Tumorais/análise
Neoplasias da Mama/patologia
Carcinoma Ductal de Mama/secundário
Carcinoma Lobular/secundário
Carcinomatose Meníngea/secundário
[Mh] Termos MeSH secundário: Adulto
Idoso
Biomarcadores Tumorais/genética
Biópsia
Neoplasias da Mama/química
Neoplasias da Mama/mortalidade
Carcinoma Ductal de Mama/química
Carcinoma Ductal de Mama/mortalidade
Carcinoma Lobular/química
Carcinoma Lobular/mortalidade
Bases de Dados Factuais
Feminino
Seres Humanos
Illinois
Imuno-Histoquímica
Hibridização in Situ Fluorescente
Carcinomatose Meníngea/mortalidade
Meia-Idade
Gradação de Tumores
Receptor ErbB-2/análise
Receptor ErbB-2/genética
Receptores Estrogênicos/análise
Receptores de Progesterona/análise
Estudos Retrospectivos
Análise de Sobrevida
Fatores de Tempo
Neoplasias de Mama Triplo Negativas/química
Neoplasias de Mama Triplo Negativas/mortalidade
Neoplasias de Mama Triplo Negativas/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (Receptors, Estrogen); 0 (Receptors, Progesterone); EC 2.7.10.1 (ERBB2 protein, human); EC 2.7.10.1 (Receptor, ErbB-2)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170530
[Lr] Data última revisão:
170530
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170224
[St] Status:MEDLINE
[do] DOI:10.1159/000455115


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[PMID]:28223673
[Au] Autor:Hikima K; Nagayama M; Sato T; Inoue T; Nagai M
[Ad] Endereço:Dept. of Internal Medicine, Sano Kosei General Hospital.
[Ti] Título:[A Case of Meningeal Carcinomatosis and Small Cell Lung Carcinoma Effectively Treated Using a Multidisciplinary Approach].
[So] Source:Gan To Kagaku Ryoho;44(2):153-155, 2017 Feb.
[Is] ISSN:0385-0684
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 65-year-old man visited our hospital with dyspnea and cough. He was diagnosed with small cell lung carcinoma (cT4N2M1b, Stage IV). The disease partially responded to systemic chemotherapy. However, it was progressive and metastasized to the brain 3 months after 6 courses of chemotherapy. Therefore, whole brain irradiation was performed. Subsequently, weakness of the lower extremities and vesicorectal disturbances appeared. Meningeal carcinomatosis was diagnosed by enhanced magnetic resonance imaging and liquid examination. Methotrexate plus cytarabine plus dexamethasone was injected intrathecally and spinal irradiation was performed. An Ommaya reservoir was placed and intrathecal chemotherapy was continued. Systemic chemotherapy was also administered. Consequently, his symptoms improved and he was successfully discharged. Therefore, a multidisciplinary approach should be considered to improve the symptoms of patients with meningeal carcinomatosis.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Quimiorradioterapia
Neoplasias Pulmonares/terapia
Carcinomatose Meníngea/terapia
Carcinoma de Pequenas Células do Pulmão/terapia
[Mh] Termos MeSH secundário: Idoso
Seres Humanos
Neoplasias Pulmonares/patologia
Masculino
Carcinomatose Meníngea/secundário
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE


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[PMID]:28215459
[Au] Autor:Mayer RR; Frankfort BJ; Strickland BA; Debnam JM; McCutcheon IE; Groves MD; Weinberg JS
[Ad] Endereço:Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA; Department of Neurosurgery, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA. Electronic address: rrmayer@bcm.edu.
[Ti] Título:Leptomeningeal metastases presenting exclusively with ocular disturbance in 34 patients: A tertiary care cancer hospital experience.
[So] Source:J Clin Neurosci;39:151-154, 2017 May.
[Is] ISSN:1532-2653
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:Leptomeningeal disease (LMD) represents disseminated intracranial metastatic disease that requires early detection and initiation of therapy. Patients with LMD typically present with a variety of neurologic problems, including ocular disturbances. However, little is reported on LMD presenting exclusively with ocular-related disturbances in the absence of any other central nervous system (CNS) dysfunction. Our goal was to describe the workup for ocular disturbances in the setting of known cancer diagnosis. Retrospective case study utilizing prospectively collected database at a tertiary cancer care center for all patients with diagnosis of LMD between 2001 and 2009. Main outcome was descriptive analysis of ocular findings by primary or admitting service with or without formal ophthalmology exam in workup for LMD. 34 patients demonstrated ocular disturbances without any other CNS manifestations. Our findings demonstrate that 71% of ocular disturbances were detected by the primary admitting services. Formal consultation with ophthalmology resulted in the detection of the remaining cases. The most common findings were cranial nerve deficits, papilledema, and optic disc or retinal infiltration by tumor. These findings supported a further work-up for CNS disease. Therefore, it is appropriate to refer cancer patients with visual complaints or findings on exam to ophthalmology to evaluate for evidence suggestive of LMD that may support a further work-up.
[Mh] Termos MeSH primário: Institutos de Câncer
Carcinomatose Meníngea/complicações
Carcinomatose Meníngea/diagnóstico
Centros de Atenção Terciária
Transtornos da Visão/diagnóstico
Transtornos da Visão/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Diagnóstico Diferencial
Feminino
Seres Humanos
Masculino
Carcinomatose Meníngea/terapia
Meia-Idade
Estudos Prospectivos
Estudos Retrospectivos
Atenção Terciária à Saúde/métodos
Transtornos da Visão/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170523
[Lr] Data última revisão:
170523
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170221
[St] Status:MEDLINE


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[PMID]:28138027
[Au] Autor:Nanjo S; Arai S; Wang W; Takeuchi S; Yamada T; Hata A; Katakami N; Okada Y; Yano S
[Ad] Endereço:Division of Medical Oncology, Kanazawa University Cancer Research Institute, Kanazawa, Japan.
[Ti] Título: Copy Number Gain Is Associated with Gefitinib Resistance in Leptomeningeal Carcinomatosis of -mutant Lung Cancer.
[So] Source:Mol Cancer Ther;16(3):506-515, 2017 Mar.
[Is] ISSN:1538-8514
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Leptomeningeal carcinomatosis occurs frequently in -mutant lung cancer, and develops acquired resistance to EGFR tyrosine kinase inhibitors (EGFR-TKIs). This study aimed to clarify the mechanism of EGFR-TKI resistance in leptomeningeal carcinomatosis and seek for a novel therapeutic strategy. We examined mutations, including the T790M gatekeeper mutation, in 32 re-biopsy specimens from 12 leptomeningeal carcinomatosis and 20 extracranial lesions of -mutant lung cancer patients who became refractory to EGFR-TKI treatment. All the 32 specimens had the same baseline mutations, but the T790M mutation was less frequent in leptomeningeal carcinomatosis specimens than in extracranial specimens (8% vs. 55%, < 0.01). To study molecular mechanisms of acquired EGFR-TKI resistance in leptomeningeal carcinomatosis, we utilized our previously developed mouse model of leptomeningeal carcinomatosis with the -mutant lung cancer cell line PC-9/ffluc cells, in which acquired resistance to gefitinib was induced by continuous oral treatment. Compared with subcutaneously inoculated gefitinib-resistant tumors, the T790M mutation was less frequent in leptomeningeal carcinomatosis that acquired resistance to gefitinib. PC-9/LMC-GR cells were established from the gefitinib-resistant leptomeningeal carcinomatosis model, and they were found to be intermediately resistant to gefitinib and osimertinib (third-generation EGFR-TKI). Although -T790M was negative, gefitinib resistance of PC-9/LMC-GR cells was related to copy number gain with MET activation. Moreover, combined use of EGFR-TKI and crizotinib, a MET inhibitor, dramatically regressed leptomeningeal carcinomatosis with acquired resistance to gefitinib or osimertinib. These findings suggest that combination therapy with MET inhibitors may be promising for controlling leptomeningeal carcinomatosis that acquires resistance to EGFR-TKIs. .
[Mh] Termos MeSH primário: Antineoplásicos/farmacologia
Resistência a Medicamentos Antineoplásicos/genética
Dosagem de Genes
Carcinomatose Meníngea/genética
Segunda Neoplasia Primária
Inibidores de Proteínas Quinases/farmacologia
Proteínas Proto-Oncogênicas c-met/genética
Quinazolinas/farmacologia
[Mh] Termos MeSH secundário: Animais
Linhagem Celular Tumoral
Modelos Animais de Doenças
Feminino
Seres Humanos
Neoplasias Pulmonares/genética
Carcinomatose Meníngea/diagnóstico
Carcinomatose Meníngea/tratamento farmacológico
Camundongos
Mutação
Receptor do Fator de Crescimento Epidérmico/genética
Ensaios Antitumorais Modelo de Xenoenxerto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Protein Kinase Inhibitors); 0 (Quinazolines); EC 2.7.10.1 (Proto-Oncogene Proteins c-met); EC 2.7.10.1 (Receptor, Epidermal Growth Factor); S65743JHBS (gefitinib)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170629
[Lr] Data última revisão:
170629
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.1158/1535-7163.MCT-16-0522


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[PMID]:28110254
[Au] Autor:Remon J; Le Rhun E; Besse B
[Ad] Endereço:Gustave Roussy, Medical Oncology Department, Villejuif, France. Electronic address: JORDI.REMON-MASIP@gustaveroussy.fr.
[Ti] Título:Leptomeningeal carcinomatosis in non-small cell lung cancer patients: A continuing challenge in the personalized treatment era.
[So] Source:Cancer Treat Rev;53:128-137, 2017 Feb.
[Is] ISSN:1532-1967
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Leptomeningeal metastasis is a fatal manifestation seen in advanced cancer patients. Its incidence is increasing, reaching 3.8% in molecularly unselected non-small cell lung cancer patients and up to 5% and 9% in ALK-rearranged and EGFR-mutant lung cancer patients, respectively. The prognosis remains poor despite systemic treatment, intrathecal chemotherapy, radiation therapy and personalized treatments in molecularly selected patients. However, new therapies with improved cerebral-spinal fluid penetration have been developed for subgroups of molecular selected patients indicating they could be promising therapeutic options for managing leptomeningeal disease. Systemic chemotherapy, which may be combined with intrathecal chemotherapy, remains standard treatment for lung cancer patients with leptomeningeal disease and a good-risk profile. We summarize evidence reported in the literature for managing this complication in lung cancer patients. Based on this, we have selected potential therapeutic strategies that could be used in daily clinical practice.
[Mh] Termos MeSH primário: Carcinoma Pulmonar de Células não Pequenas/patologia
Neoplasias Pulmonares/patologia
Carcinomatose Meníngea/tratamento farmacológico
[Mh] Termos MeSH secundário: Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico
Seres Humanos
Neoplasias Pulmonares/tratamento farmacológico
Carcinomatose Meníngea/secundário
Medicina de Precisão/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170210
[Lr] Data última revisão:
170210
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170123
[St] Status:MEDLINE


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[PMID]:28084680
[Au] Autor:Tinkle CL; Orr BA; Lucas JT; Klimo P; Patay Z; Baker SJ; Broniscer A; Qaddoumi I
[Ad] Endereço:Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
[Ti] Título:Rapid and fulminant leptomeningeal spread following radiotherapy in diffuse intrinsic pontine glioma.
[So] Source:Pediatr Blood Cancer;64(8), 2017 Aug.
[Is] ISSN:1545-5017
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 4-year-old male presented with rapid-onset cranial nerve palsy and ataxia. Brain magnetic resonance imaging (MRI) revealed a pontine mass lesion with discordant conventional and advanced imaging. A stereotactic core biopsy revealed glioblastoma with immunostaining suggestive of histone H3K27M and TP53 mutation, consistent with diffuse intrinsic pontine glioma. MRI 3 months after radiotherapy revealed extensive new leptomeningeal metastatic disease involving both the supra- and infratentorial brain, as well as the imaged portion of the spine. Tissue procured at the time of needle biopsy has undergone striking in vivo expansion as an orthotopic xenograft.
[Mh] Termos MeSH primário: Neoplasias do Tronco Encefálico/patologia
Neoplasias do Tronco Encefálico/radioterapia
Glioblastoma/patologia
Glioblastoma/radioterapia
Carcinomatose Meníngea/patologia
[Mh] Termos MeSH secundário: Pré-Escolar
Progressão da Doença
Evolução Fatal
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170114
[St] Status:MEDLINE
[do] DOI:10.1002/pbc.26416



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