Here we presented a 44 yr old male patient with an abdominal pain who had a distal gastric adenocarcinoma in his endoscopic biopsy. The pathology reported a chromogranine negative, CK20-positive, ...PD-L1 5% positive adenocarcinoma with MLH1 (-)and PMS-2(-) MSI status. PET/CT showed enlarged gastric wall (SUVmax 23.99) and enlarged perigastric lymphadenopathy (SUVmax 22.03) and no distant metastasis.
The patient received 4 courses of Nivolumab plus FLOT-4 chemoimmunothrapy in neoadjuvant setting. He experienced Grade 2 myelotoxicity and 2 packages of red blood were transfused. Following 4 courses of chemoimmunotherapy a total gasterectomy was performed and the pathology reported no evidence of tumor in the stomach and also perigastric lymph-nodes revealing a pathological complete response.
There has been no standart treatment for MSI-high gastric cancer, yet. Very few phase I-II studies wth limited number of patients suggest an immunotherapy-based treatment.
Here we report a combination regimen of original FLOT-4 chemotherapy with an PD-L1 Ab (nivolumab) that resulted a pCR in the neoadjuvant setting. Four courses of the same chemotherapy was planned in the adjuvant setting.
Here we report 2 patients presenting with bulky lymphadenopathy in the abdominopelvic region.
The first patient was a 64 yr old man and a lymph node biopsy from inguinal region revealed a ...CD23-positive, CD20-negative, CXCL13-positive and Ki67 40% positive follicular dendritic cell sarcoma. The patient received 6 courses of chemotherapy combined with PD-1 MoAb (pembrolizumab. A gemcitabine plus docetaxel regimene (GemDoc) combined with 200 mg pembrolizumab. At the end of 6 courses, PET/CT presented a metabolic CR. We continue the same cheomoimmuno regimene as maintenance treatment.
The second patient is a 44 year old man who has an intraabdominal bulky tumor and multiple hepatic metastasis. Core biopsies from liver lesions and intra-abdominal mass revealed FDCS. The patient took the first course of the same regimene of chemoimmunotherapy composed of a GemDoc+pembrolizumab and felt comfortable because of the decrease in tumor sizes.
A very rare entity, FDCS has no a standart treatment, yet. We combine a second line sarcoma regimen (GemDoc) with Anti-PD1 Ab, pembrolizumab as induction systemic treatment and followed by a maintenance Pembrolizumab. This chemoimmunotherapy regimen suggest that it will work in FDCS patients who have intermediate PD-L1 expression in tumor cells.
The adverse effects of chemotherapy are more apparent in elderly patients and lead to worse prognosis and mortality. Identifying immunonutritional risk factors is of great importance in terms of ...treatment effectiveness, prognosis, and mortality in geriatric oncology. The modified Glasgow prognostic score (mGPS) is an immunonutritional index based on serum CRP and albumin levels. In this study, we aimed to investigate the role of mGPS in predicting prognosis and survival in elderly patients with gastric cancer receiving perioperative FLOT treatment. We retrospectively enrolled 71 patients aged over 65 years and grouped them according to their pretreatment mGPS score. Kaplan-Meier and Cox regression analysis showed overall survival was significantly worse in the mGPS 1 and mGPS 2 groups than in the mGPS 0 group (p = 0.005 and p < 0.001, respectively). Compared to the mGPS 0 group, the mGPS 1 group had a 6.25 times greater risk of death (95% CI: 1.61–24.28, p = 0.008), and the mGPS 2 group had a 6.59 times greater risk of death (95% CI: 2.08–20.85, p = 0.001). High BMI was identified as a significant risk factor for being in the mGPS 2 group (OR: 1.20, 95% CI: 1.018–1.425, p = 0.030). In conclusion, elevated pretreatment mGPS was associated with poor overall survival in elderly patients with gastric cancer treated with perioperative FLOT therapy. As such, pretreatment mGPS can be a simple and useful tool to predict mortality in this specific patient group.
Rituximab (the chimeric anti-CD20 antibody) is widely used in the treatment of CD20 positive non-Hodgkin’s lymphoma (NHL). The response rate at relapse after repeated use in prior CD20 positive ...responders is lower than 50%. Several mechanisms can be responsible for rituximab resistance. CD20 negative relapses which transformed from CD20 positive aggressive and indolent forms of lymphoma can be the one of the reason of secondary resistance to rituximab. The authors report a case with combination of aggressive and indolent form of lymphoma who relapsed after 7 months from the last dose of rituximab therapy. CD20 transformed negative from positive in her relapsed disease. Patients with CD20 positive B cell NHL must rebiopsy after first line rituximab therapy if their disease relapsed or progressed.
: The purposes of neoadjuvant chemotherapy are to tumor size to improve the tumor removal rate, extend survival, and prevent metastasis. In this study, the importance of CRP/albumin ratio and ...CEA/albumin ratio in the prediction of neoadjuvant treatment response in gastric cancer patients was evaluated.
: This study retrospectively included 135 gastric cancer patients who received neoadjuvant chemotherapy at Çukurova University Balcalı Hospital between January 2018 and December 2023. Preoperative CRP/albumin and CEA/albumin ratios were compared according to treatment response and multivariate logistic regression analysis was performed to determine the potential importance of these ratios in predicting pathological response.
: The mean age of the 135 patients was 58.79 ± 10.83 (min = 26-max = 78). The CRP/albumin and CEA/albumin ratios were found to be significantly lower in patients who did not respond to neoadjuvant therapy. Each 1-unit increase in the CRP/albumin ratio was associated with a 1.16-fold decrease in the odds of pathological complete response to neoadjuvant therapy. Both CRP/albumin and CEA/albumin ratios were found to be significant in distinguishing neoadjuvant therapy response. The optimal cut-off value was 2.74 for the CRP/albumin ratio (sensitivity = 60%, specificity = 78.4%) and 1.40 for the CEA/albumin ratio (sensitivity = 74.2%, specificity = 67.6%). Values below these cut-off points favored neoadjuvant therapy response. Pathological complete response to neoadjuvant therapy was 4.75 times higher in patients with a CRP/albumin ratio below 2.74 and 5.14 times higher in patients with a CEA/albumin ratio below 1.40.
: Findings demonstrate that in patients with locally advanced gastric cancer receiving neoadjuvant treatment, CRP/Albumin and CEA/Albumin ratios are significant markers of pathological response.
Hepatocellular carcinoma has still been one of the cancer with increasing incidence and highest mortality rate in the world. Although many new promising developments have been defined in ...hepatocarcinogenesis, with a short survival the treatment of patients with advanced hepatocellular carcinoma is an emerging issue. On the recent decade, only one anti-angiogenic agent sorafenib improved overall survival with costing a hardly manageable toxicity. Novel immunotherapeutic agents, especially immune checkpoint inhibitors are on the edge of more effective but less toxic treatments for these patients. In this article the activity of immune checkpoint inhibitors, anti-CTLA-4 and anti-PD1 antibodies for the treatment of patients with advanced hepatocellular cancer will be reviewed.
Lymphoma of the breast in a male patient Duman, Berna Bozkurt; Şahin, Berksoy; Güvenç, Birol ...
Medical oncology (Northwood, London, England),
12/2011, Letnik:
28, Številka:
Suppl 1
Journal Article
Recenzirano
Primary lymphoma of the breast is very rare especially in a male patient. Treatment alternatives include surgery, chemotherapy, immunotherapy and radiation. It is still controversial which ...combination is the best. Here, we report a male patient who presented with a left breast mass. The excisional biopsy was applied, and pathological assessment revealed marginal zone lymphoma. Both conventional computed tomography and 18)F-Fluorodeoxyglucose positron emission tomography/computed tomography were used for staging. The clinical stage was IIE for Ann Arbor staging and so local radiation following chemo immunotherapy was planned. Left-sided primary breast lymphoma in a male patient is a very rare entity. Treatment modalities are still controversial. Some authors believe that primary breast lymphomas have poor prognosis, and they must be treated aggressively with combined treatment modalities. Another important point is that 18)F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET)/CT could be used for staging of disease and assessing treatment response in a patient with primary breast marginal zone lymphoma.
The aim of this study was to investigate the general characteristics of patients with deep vein thrombosis (DVT) and pancreatic cancer as well as evaluate the relationship between mean platelet ...volume (MPV), DVT and survival.
Seventy-seven patients with pancreatic cancer, who were admitted to Cukurova University Medical Faculty, Department of Medical Oncology, were enrolled in the study
The mean age was 59±20. Forty-nine (63.6%) were men and 28 women (36.4%) . Sixty-eight (88.3%) patients had adenocarcinoma and 9 (11.7%) had a malignant epithelial tumor. Thirty-six (46.7%) had liver metastasis at diagnosis. Twenty-six (33.8%) patients were alive, 20 (26%) were dead and in 31 (40.2%) the status was unknown. Only 14 (18.1%) patients had DVT. In 42 (54.5%) patients MPV values were normal, in 28 (36.4%) patients they were above normal, and in 7 (9.1%) patients they were below normal. There was no statistically significant difference between gender, tumour localization, chemotherapy and survival rates (p:0.56, p:0.11, p:0.21). There was no significant difference between DVT, gender, localisation, histological subtype, the presence of metastasis, stage and if the patient had been treated with chemotherapy (p:0.5, p:0.6, p:0.2, p:0.32, p:0.1, p:0.84). There was also no significant difference between MPV and DVT (p:0.57) but there was a significant difference between liver metastasis and DVT (p:0.02). Age, stage, the presence of metastasis and DVT were prognostic in pancreatic cancer patients.
Cases of pancreatic cancer with liver metastasis should be studied more carefully as thrombosis is more common in these patients.
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