An Unusual Case of Aplastic Anemia Caused by Temozolomide

Radiotherapy and concomitant/adjuvant therapy with temozolomide are a common treatment regimen for children and adults with high-grade glioma. Although temozolomide is generally safe, it can rarely cause life-threatening complications. Here we report a case of a 31-year-old female patient who underwent surgical resection followed by radiotherapy plus concomitant temozolomide. She developed pancytopenia after adjuvant treatment with temozolomide. A bone marrow aspiration and biopsy showed hypocellularity with very few erythroid and myeloid cells, consistent with aplastic anemia. In the English literature, aplastic anemia due to temozolomide is extremely rare

Patients' preferences for subcutaneous trastuzumab versus conventional intravenous infusion for the adjuvant treatment of HER2-positive early breast cancer: final analysis of 488 patients in the international, randomized, two-cohort PrefHer study

PrefHer revealed compelling and consistent patient preference for subcutaneous (s.c.) trastuzumab, regardless of delivery by single-use injection device or hand-held syringe. s.c. trastuzumab was well-tolerated and safety data, including immunogenicity, were consistent with previous reports. No new safety signals were identified compared with the known intravenous trastuzumab profile in early breast cance

Isolated bone marrow natural killer cell lymphoma with central nervous system involvement mimicking a cerebral infarct

Background: We describe the case of an isolated bone marrow natural killer (NK) cell lymphoma with central nervous system (CNS) involvement mimicking a cerebral infarct. CNS involvement in isolated bone marrow lymphoma has not been reported previously. Case Report: A 49-year-old man with complaints of fever, confusion, and agitation was presented. A bone marrow biopsy was performed to investigate the etiology of bicytopenia which was consistent with NK-cell lymphoma. Brain MRI findings were suggestive of a subacute infarct. Conclusion: Even if pathological signal changes of the brain without contrast enhancement resembling infarct are detected in patients with lymphoma on the magnetic resonance imaging, CNS involvement of the lymphoma should be kept in mind in the differential diagnosis

Irinotecan as a Second-line Monotherapy for Small Cell Lung Cancer

Objectives: The present study was designed to investigate the efficacy of irinotecan monotherapy as a second-line treatment for small cell lung cancers (SCLCs). Methods: Irinotecan monotherapy was administered to 46 SCLC patients who were previously undergone cisplatin based chemotherapy protocols. Response to treatment, time to progression (TTP), overall survival rates and adverse events associated with irinotecan monotherapy (300mg/m2; total 153 cycles; mean 3.78 +/- 1.98) were determined, retrospectively. Results: Limited stage disease was diagnosed in 19.6% of patients (n=9) while 80.4% (n=37) were diagnosed with extensive stage cancer preceeding the irinotecan monotherapy. None of the patients had complete response to irinotecan. Partial response and stable disease were achieved among 17.5% of patients. Mean time to tumor progression (TTP) was determined to be 11.3 +/- 5.94 weeks while overall survival was 13.3 +/- 6.83 months. Considering adverse events, grade 3 and 4 toxicity was encountered in 8.9% and 4.5% of patients, respectively. Irinotecan monotherapy in brain metastasized tumors was found to be associated with significantly higher survival times compared with tumors lacking brain metastasis (15.0 +/- 5.95 vs 10.7 +/- 4.82 months; p<0.05). Conclusions: Irinotecan as a monotherapy in the second-line treatment of SCLC seems to have an acceptable level of toxicity and significant palliative effects. The prominent survival step-up effect particularly in brain metastasis patients appears worthy of note

Importance of HER2 Work-Up and Treatment Even in Patients with Poor Performance Status: A Case Report

Gastric cancer is one of most common types of cancers. Metastatic gastric cancer has a poor prognosis and is accepted as incurable at this stage. Treatment of metastatic gastric cancer did not progress substantially until new targeted agents have come out. Recently published ToGA trial showed promising results in HER2 overexpressing metastatic gastric cancer. In this case we present a case with an excellent complete response with anti-HER2 treatment. Most importantly, we wanted to emphasize (1) the importance of early determination of HER2 overexpression, and (2) to draw attention of anti-HER2 agents in the first line treatment even in patients with a poor performance status