Madam S, who diagnosed to have stage IV lung adenocarcinoma with exon 21 L858R point mutation (T3N2M1a) was admitted for massive pericardial effusion in April 2016. She was ECOG 4 on admission. Her ECOG improved to 1 after pericardial tapping and initiation of free sample erlotinib 100 mg daily. Repeated CT thorax post treatment showed the disease was partial responded. Due to financial constraints, she had never bought any EGFR-TKI. She was given a free sample of erlotinib intermittently for total of 12 months followed by intermittent afatinib supply for 2 years. Due to this limited supply, she took half doses of afatinib by cutting a 40 mg tablet once every few days to sustain the continuation of cancer treatment. No major side effects were observed and she remained ECOG 0 with good weight gain. Up to her last clinic visit in September 2021, her PFS was more than 5 years. Intermittent doses of EGFR-TKI may prolong PFS in patients with advanced EGFRm+ NSCLC who has limited treatment options.

Pulmonary herpes simplex infection is rarely reported. To date, there is a paucity of literature on this infection. This case study describes a 64-year-old male with a background history of diabetes mellitus and hypertension who was intubated for acute respiratory failure. The managing team had difficulty to wean his oxygenation thus decided for bronchoscopy examination which showed suspicious growth at middle lobe of the right lung. Repeated bronchoscopy by pulmonologist revealed a nodular ‘warty’ appearance lesion at right bronchus intermedius. His biopsy revealed histopathological changes consistent with herpes simplex infection.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 112-114

Atypical lung carcinoid tumour, which is highly malignant has not been described widely in the literature. We report a middle-age woman who initially referred for possible lung malignancy. She presented with chronic diarrhoea to surgical team initially, who incidentally found to have a minimally enhancing irregular hypodense lesion at medial segment right lower lobe based on CT thorax finding. This patient later was diagnosed to have malignant lung carcinoid tumour based on histopathological examination with liver and bone metastasis. This case highlights the rare presentation of carcinoid tumour. A thorough history, supplemented by imaging and bronchoscopic examinations may lead to the diagnosis.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 108-111

Biosensing technologies can be used for toxicity studies on cell cultures. The xCELLigence Real-Time Cell Analysis (RTCA) system is a portable label-free detection method with the capability to analyze cellular proliferation, migration, invasion, growth, morphology states, and cytotoxicity of adherent cells in a non-invasive environment. In pharmacological context, most xCELLigence studies were done using cancer cell lines. Hypothetically, implementing the system with primary cell culture can anticipate actions in vivo better than those seen on cell lines. This could potentially provide useful information on how the drug responds to targeted cancer. In this work, we explore the usage of biosensing technology to establish a concept for high-throughput testing of chemotherapeutics agents on primary patient-derived cancer cells. Four self-established primary lung cancer cells (samples A36, A38, A39, and A40) were derived from biopsies of patients, cultured, and tested with cisplatin. The xCELLigence was used to monitor the response of primary lung cancer cells toward different concentrations of cisplatin ranging from 1 to 120 μM. Cisplatin was found to be effective at approximately 20 μM after 48 h of exposure with A38 and A39 showing drug resistance behavior at below 20 μM concentration. The IC 50 values were between 22.88 to 76.22 μM. This indicates that the RTCA biosensor technology has good potential in predicting the cell's response to chemotherapy especially when primary cancer cells are used. This approach can be the fundamental reference in the future to support personalized chemotherapy treatment by providing additional information on metastatic behavior, cytotoxic and drug-resistance effects of the cancer cells.