Long-Term Survival after Second-Line Therapy with Docetaxel and Carboplatin and Monthly Pamidronic Acid in a Woman with Metastatic Non-Small Cell Lung Cancer

Andritzky, Birte; Schuch, Gunter; Thoem, Ina; Goern, Michael; Brandl, Stephan; Bokemeyer, Carsten; Laack, Eckart

doi:10.1159/000092263

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…Radiation therapy was able to provide durable CNS control in nearly all patients, while systemic failures remained the leading cause of death. Prospective studies on treatment intensification [14][15][16] and quality of life in this patient subgroup appear warranted. …”

Section: Discussionmentioning

confidence: 99%

Disease Presentation and Treatment Outcome in Very Young Patients with Brain Metastases from Lung Cancer

Nieder

Thamm²,

Astner³

et al. 2008

Onkologie

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Background: While elderly patients with brain metastases from lung cancer appear to have an unfavorable prognosis, little information is available on disease presentation and treatment outcome in very young patients. Patients and Methods: Retrospective evaluation of radiation therapy in this particular subpopulation. The database with 149 lung cancer patients contained 9 patients aged <40 years. The majority received whole-brain radiation therapy with 30 Gy in 10 fractions plus steroids, with or without other local or systemic measures according to the institutional policy. Results: Five patients had small-cell histology. Median Karnofsky performance score was 70. In 6 cases, brain metastases were present already at first diagnosis. Eight patients had multiple lesions. Of 8 patients with complete follow-up, only 1 died from spread to the central nervous system (CNS), all others from extracranial disease. Maximum survival was 26 months (median 7 months). Conclusion: Very young patients with brain metastases did not achieve a better outcome than intermediate age groups. Radiation therapy was able to provide durable CNS control in nearly all patients, while systemic failures remained the leading cause of death. Prospective studies on treatment intensification and quality of life in these patients appear warranted.

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Section: Discussionmentioning

confidence: 99%

Disease Presentation and Treatment Outcome in Very Young Patients with Brain Metastases from Lung Cancer

Nieder

Thamm²,

Astner³

et al. 2008

Onkologie

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“…DOC+RAM therapy has been evaluated as one of the standard treatments for second or later-line therapy for patients with advanced NSCLC (5-8). Although there have been reports of patients with long-term responses to DOC without RAM (20,21), combination with RAM has been shown to extend the duration of response (5)(6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

NSCLC Patients Achieving Long-term Progression-free Survival With Docetaxel Plus Ramucirumab: A Retrospective Study

Miyazaki¹,

Shiozawa

Okauchi

et al. 2023

CDP

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Background/Aim: The antineoplastic drug docetaxel (DOC) and the antivascular endothelial growth factor inhibitor ramucirumab (RAM) are widely used in combination for second or later-line regimens for advanced non-small cell lung cancer (NSCLC). While the median progression-free survival (PFS) of DOC+RAM has been reported to be less than six months in both clinical trials and clinical practice, there appear to be some patients with long-term PFS. This study aimed to clarify the existence and characteristics of these patients. Patients and Methods: We conducted a retrospective review of patients with advanced NSCLC treated with DOC+RAM between April 2009 and June 2022 at our three hospitals. There was no established definition of long-term PFS, thus in this study, a PFS of 12 months or longer was defined as long-term PFS. Results: During the study period, 91 patients received DOC+RAM treatment. Of these, 14 (15.4%) achieved long-term PFS. There were no significant differences in patient characteristics between patients with PFS ≥12 months and those with PFS <12 months, except for ‘clinical stage IIIA-C’ at DOC+RAM initiation and ‘post-surgical recurrence’. In uni- and multivariate analyses, favorable factors for PFS were ‘Stage III at the start of DOC+RAM’ in driver gene-negative patients, and ‘under 70 years old’ in driver gene-positive patients. Conclusion: Many patients in this study achieved long-term PFS with DOC+RAM treatment. In the future, it is expected that long-term PFS will be defined, and the background of patients who achieve such PFS will become clearer.

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“…Our patient was a woman diagnosed with adenocarcinoma of the lung, and as such, might have two advantages of gender and histology. Long-term survivors with bone metastasis have rarely been reported [3][4][5], and complete remission incidence of bone metastasis in NSCLC patients is very low [6]. Although very rare, we recommend possible consideration of a treatment with gefitinib for female patients with bone metastasis due to adenocarcinoma of the lung, even if they are not indicated for other intensive therapy.…”

mentioning

confidence: 99%

Prolonged response to gefitinib in bone metastasis

et al. 2008

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Gefitinib is an oral selective inhibitor of the epidermal growth factor receptor (EGFR) tyrosine kinase, and is regarded as a safe agent, although some toxic effects such as interstitial pneumonia exist [1,2]. Gefitinib is now being attempted for patients with advanced non-small cell lung cancer (NSCLC). We herein report a lung adenocarcinoma patient who obtained regression of bone metastasis by gefitinib therapy.A 63-year-old woman with no smoking history was admitted because of a nodular lesion that was detected incidentally by a chest radiograph. She complained back pain, and a painkilling drug was administrated. Chest CT scan demonstrated a 3.5 9 2.5 cm left lung mass with multiple intrapulmonary metastases. A magnetic resonance imaging (MRI) revealed hypointense on a T1-weighted and hyperintense on a T2-weighted image of the vertebral bodies of the seventh thoracic (T7) and the third cervical spine (C3). Similar image was observed in the left transverse process of the second lumbar spine (L2). MRI also showed the compression fracture of the vertebral body of T7. Pathology samples obtained by transbronchial biopsy confirmed adenocarcinoma of the lung. Bone scan showed marked accumulation in these vertebral bones (C3, T7, and L2) (Fig. 1a). She had one course of chemotherapy combined with carboplatin and paclitaxel, but the response was evaluated as progressive disease. Thereafter, she received 250 mg gefitinib one daily, but she had no concurrent medications including biphsophonates. Pretreatment evaluation of the epidermal growth factor receptor mutation in her adenocarcinoma was not performed because of her refusal. Chest CT scan on day 28 revealed regression of intrapulmonary metastases. Two months after the start of gefitinib, back pain decreased and the use of the painkilling drug was stopped. Except for elevation of transaminase up to 60 U/ml, adverse effects considered to be possibly due to gefitinib administration including interstitial pneumonia, skin rash, and diarrhea were not observed. She received gefitinib every other day, and the liver injury was normalized. Eight months after the beginning of gefitinib, bone scan showed regression of bone metastasis (Fig. 1b). MRI also revealed regression of bone metastasis in C3, T7, and L2. Patient is currently active and able to perform her activity of daily living independently. The patient remained alive and with no evidence of bone metastasis for 2 years.We administrated gefitinib to a patient with vertebral bone metastasis due to lung adenocarcinoma. Although the patient also had multiple intrapulmonary metastases, a remarkable antitumor activity was obtained without any serious adverse effects. Both female gender and adenocarcinoma are identified as favorable prognostic factors in a multivariate analysis of patients in previous randomized double blind trials [1, 2]. Our patient was a woman diagnosed with adenocarcinoma of the lung, and as such, might have two advantages of gender and histology. Long-term survivors with bone metastasis have rarely been ...

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Long-Term Survival after Second-Line Therapy with Docetaxel and Carboplatin and Monthly Pamidronic Acid in a Woman with Metastatic Non-Small Cell Lung Cancer

Cited by 3 publications

References 16 publications

Disease Presentation and Treatment Outcome in Very Young Patients with Brain Metastases from Lung Cancer

Disease Presentation and Treatment Outcome in Very Young Patients with Brain Metastases from Lung Cancer

NSCLC Patients Achieving Long-term Progression-free Survival With Docetaxel Plus Ramucirumab: A Retrospective Study

Prolonged response to gefitinib in bone metastasis

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