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Background: Panitumumab is an EGFR inhibitor used for the treatment of metastatic colorectal cancer (mCRC), even if its use is related to skin toxicity. Case Presentation: We report the development of forearm panniculitis in two women during the treatment with Panitumumab (6 mg/Kg intravenous every 2 weeks) + FOLFOX-6 (leucovorin, 5- fluorouracil, and oxaliplatin at higher dosage) for the treatment of mCRC. Results: In both patients, clinical, laboratory and radiological evaluation documented the presence of a local panniculitis, probably related to panitumumab (Naranjo score: 6). Panatimumab discontinuation and antimicrobial + corticosteroid treatment induced a remission of skin manifestations. Conclusion: We reported for the first time the development of panniculitis during Panitumumab treatment, and we documented that the treatment with beta-lactams to either fluoroquinolones or oxazolidinone in the presence of corticosteroid improves clinical symptoms in young patients with mCRC, without the development of adverse drug reactions or drug-drug interactions.

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Background: FGFR2 fusions and rearrangements occurring in 10e16% of patients with intrahepatic cholangiocarcinoma (ICC) reported in published scientific literature. Pemigatinib, a selective FGFR inhibitor, has demonstrated the high therapeutic potentials for ICC patients with FGFR2 fusions or rearrangements, according to the results of FIGHT 202 study. Whereas in Chinese population, the epidemiological data of FGFR2 fusions and rearrangements is still insufficient with limited sample sizes, and partner genes in FGFR2 fusion are still unknown.Methods: A total of 728 pathologically confirmed ICC samples (including surgical and biopsy samples from 728 patients aged over 18 years) were collected and tested FGFR2 fusion or rearrangement using fluorescence in situ hybridization (FISH) with break-apart probes. Thirty samples with known FGFR2 fusion or rearrangement were tested with next generation sequence (NGS) to identify the partner genes of FGFR2.Results: As of October 31, 2020, 728 patients were included and their samples were tested for FGFR2 gene fusion or rearrangement, 717 samples had readout. Forty-four samples (44/717, 6.14%) were tested FGFR2 gene fusion or rearrangement positive. Regionally, the highest positive rate (10.5%) was found in Southwest China (Sichuan and Yunnan province), and the lowest positive rate (5%) was in South China (Guangdong and Guangxi province). Twenty-six different FGFR2 fusion partner genes were identified in 30 samples, 22 (84.6%) of which were unique to individual patients. The most common partner was FGFR2-WAC (3/30, 10%).Conclusions: Based on a large sample size, the rate of FGFR2 gene fusion or rearrangement in Chinese ICC patients was 6.14%, and the FGFR2 partner genes were highly heterogeneous.Clinical trial identification: NCT04256980.

Vaccination with ChAdOx1 nCoV-19 can result in vaccine-induced immune thrombotic thrombocytopenia (VITT). This phenomenon mimics heparin-induced thrombocytopenia, yet it does not require heparin as a trigger. This case report highlights the potentially lifethreatening complication associated with ChAdOx1 nCov-19 vaccine, clinical presentation, diagnostic approach, and treatment. We report two cases of vaccine-induced immune thrombotic thrombocytopenia after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. We attribute these thrombotic conditions to the vaccine due to the remarkable temporal relationship. The proposed mechanism of VITT is a production of antibodies against platelet factor-4 resulting in massive platelet activation. Healthcare providers should be aware of the possibility of such a fatal complication, and the vaccine recipients should be warned about the symptoms of VITT.