Resistance to thyroid hormone (RTH) is a genetic disorder characterized by reduced tissue responsiveness to thyroid hormone. We herein describe a 60-year old man who presented with the clinical features of cardiomyopathy, diabetes mellitus and elevated thyroid hormones with unsuppressed thyroid stimulating hormone. A genetic analysis of thyroid hormone receptor (TR) revealed a missense mutation (A268D) in the TRβ gene. Clinical manifestations of RTH may be variable due to different tissue distributions of TR subtypes and different actions of mutant receptors. The current case demonstrates that patients with a TRβ mutation may have impaired his glucose metabolism and a reduced cardiac function, although patients appear clinically euthyroid.

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CT-P6 is a biosimilar of trastuzumab and is recommended to be administered for 30-90 min in subsequent maintenance infusions to prevent infusion-related reactions (IRRs). We administered CT-P6 for 30 min as the first injection and as an alternative to reference trastuzumab in the maintenance infusion and evaluated the safety of the administration. A total of 140 patients with breast or gastric cancer, who received a switch from tri-weekly reference trastuzumab to CT-P6 for 30 min in maintenance infusions, were retrospectively evaluated. Premedication was administered prior to an infusion of CT-P6 and a cytotoxic agent. However, premedication was not provided when CT-P6 was co-administered with pertuzumab or administered alone. The primary endpoint was the incidence of IRRs. The secondary endpoint was the incidence of diarrhea and skin toxicity. Ninety-five percent of the patients had breast cancer, and 44.3% had advance-stage cancer. The treatment included CT-P6 alone (17.9%) or with cytotoxic agents (23.6%), antihormonal drugs (25.7%), and pertuzumab (62.9%). Median administration time of trastuzumab at the switch was 13 administrations (range 2-140). Premedication was administered to 20.7% patients. One patient (0.7%) experienced grade 3 IRR. The frequency of diarrhea in the reference trastuzumab group and the CT-P6 group was 7.1 and 6.4%, respectively, and that of skin toxicity was 6.4 and 5.0%, respectively, without differences. In conclusion, we first demonstrated that an initial CT-P6 administration for 30 min during the switch from reference trastuzumab in maintenance infusion is an acceptable administration method.

Background: First-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) sometimes causes lung injury, thereby affecting survival.Although pre-existing interstitial lung abnormal shadow (pre-ILS) increases the risk of lung injury by EGFR-TKIs, its impact on osimertinib, a third-generation EGFR-TKI, remains unknown. Patients and Methods:This retrospective cohort study consecutively enrolled patients of EGFR-mutated non-small cell lung cancer treated with osimertinib.Computed tomography images were obtained and evaluated independently by three pulmonologists in a blinded manner. Factors associated with lung injury were assessed using a logistic regression model. Survival curves were calculated by the Kaplan-Meier method and compared using a log-rank test.

Chemotherapy-induced neutropenia (CIN) is a dose-limiting factor for cytotoxic chemotherapy, but recently, it was suggested that CIN contributes to prolonged survival. In this study, we examined the association between severe CIN and survival, and determined whether CIN affected survival in patients with extensive-stage small cell lung cancer (ED-SCLC).The medical records from 214 patients with ED-SCLC treated with etoposide or irinotecan in combination with cisplatin (EP/IP) between 2012 and 2016 were collected and retrospectively analyzed. Landmark analysis was performed at the end of cycle 4 and the relationship between severe CIN and survival was determined by a log-rank test. In addition, a multivariate analysis using COX proportional hazard model was performed to identify independent predictive factors. The Landmark analysis included 102 patients in the IP-group and 47 patients in the EPgroup. No signi cant difference was found between grade 0-3 and grade 4 neutropenia and overall survival (OS) in the EP-group. (P = 0.57). Contrariwise, for the IP patients, the median OS was 444 days for grade 0-3 and 633 days for grade 4 neutropenia, which was signi cantly longer for patients who developed grade 4 neutropenia (P = 0.03). Multivariate analysis adjusted for potential factors revealed that the development of grade 4 CIN was identi ed as a signi cant predictor of longer OS (hazard ratio[HR], 0.46; 95% con dence interval (CI), 0.26-0.81, P = 0.008). The results indicated that the development of severe CIN with IP therapy is associated with prolonged OS. Patients and treatmentsPatients who received standard doses of IP or EP as initial therapy for advanced and previously untreated SCLC were selected from the electronic medical record system of each participating institution. A total of 214 patients were selected and divided into two groups: those who received IP (n = 138) and those who received EP (n = 76). Clinical data and assessment of CINClinical data including patient characteristics and prognostic factors were collected from each hospital's electronic medical records. Hematologic toxicity was assessed based on the Common Terminology Criteria for Adverse Events, version 5.0 (CTCAE v5.0). CIN grade was determined based on the lowest neutrophil count for each patient recorded during rst-line treatment. The endpoint of the study was severe CIN survival. This was de ned as the time from the start date of cisplatin-based chemotherapy to the date of death or the last day of the follow-up period. Statistical analysisNeutropenia occurring during the treatment period was graded (grade 0-4) according to CTCAE v5.0.Survival curves for overall survival (OS) were generated for each grade of neutropenia using the Kaplan-Meier method and compared using the log-rank test. To analyze the effect of severe CIN development on