Synchronous Duodenal Cancer and Lung Cancer Harboring an Epidermal Growth Factor Receptor Mutation Treated with Erlotinib and Oral Fluoropyrimidine

Akiyama, Nobutake; Karayama, Masato; Iwaizumi, Moriya; Kusama, Yukiko; Kono, Masato; Hozumi, Hironao; Suzuki, Yuzo; Furuhashi, Kazuki; Enomoto, Noriyuki; Fujisawa, Tomoyuki; Inui, Naoki; Suda, Takafumi

doi:10.2169/internalmedicine.8312-16

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Apart from RAS mutations, EGFR mutations were reported in approximately 2.5% of SBA [ 44 ], leading to an evaluation of EGFR tyrosine kinase inhibitors, such as erlotinib in advanced SBA. In a case report of a patient with concomitant lung and duodenal adenocarcinoma with an EGFR mutation, the treatment of erlotinib and S-1 resulted in a partial response [ 39 ] ( Table 3 ).…”

Section: Targeted Therapiesmentioning

confidence: 99%

Therapeutic Strategies for Patients with Advanced Small Bowel Adenocarcinoma: Current Knowledge and Perspectives

Moati

Overman

Zaanan

2022

Cancers

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Small bowel adenocarcinoma (SBA) is diagnosed at an advanced (unresectable or metastatic) tumor stage in approximately one-third of cases. This is partly due to the non-specific symptomatology and limitations in endoscopic and radiologic detection methods. In this context, the prognosis remains poor and systemic chemotherapy appears to benefit patients when compared to best supportive care alone, despite the absence of randomized controlled trials. The results of a recent large prospective cohort (ARCAD-NADEGE) reported that the absence of chemotherapy was a predictive factor for a lower overall survival (OS) even though poor differentiation and SBA associated with Crohn’s disease correlate with poor prognosis. In retrospective series, the median OS ranges from approximately 9 to 18 months with current treatment approaches. A combination of a fluoropyrimidine and oxaliplatin (FOLFOX or CAPOX) appears to be the most utilized and effective first-line chemotherapy regimen. Other front-line alternatives are the combination of 5-FU and cisplatin or fluoropyrimidine and irinotecan (FOLFIRI). In second-line, FOLFIRI is an effective option after progression on platinum-based therapy. Taxane-based therapy appears to be an alternative option, but further evaluation in larger series is needed. To a limited extent, the role of surgical resection for metastatic disease appears to be a valid option, though this approach has not been evaluated in prospective clinical studies. Due to the rareness of the disease, inclusion in clinical trials should be prioritized, and there is hope that targeted therapies and immunotherapy may enter the therapeutic arsenal for these patients.

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Section: Targeted Therapiesmentioning

confidence: 99%