Epidemiological characteristics, EGFR status and management patterns of advanced non-small cell lung cancer patients: The Greek REASON observational registry study

Background/Aim: Real-world evidence regarding the prevalence of epidermal growth factor receptor (EGFR) mutation-positive status (M+) and the clinicopathological characteristics associated with the presence of EGFR mutations in advanced non-small cell lung cancer (NSCLC) is scarce, especially among Caucasian populations. The present study aimed to bridge this gap, as well as to record treatment patterns and outcomes in routine-care settings. Patients and Methods: REASON (NCT01153399) was a prospective study of patients with stage IIIB/IV NSCLC and known EGFR mutation status. Clinicopathological, treatment characteristics and clinical outcomes were recorded and correlated with EGFR mutation testing results. Results: Of 575 enrolled patients, EGFR mutations were detected in 15.7% of them. Male gender (p=0.008) and smoking (p<0.001), but not adenocarcinoma, were associated with EGFR M+ status. In the EGFR M+ subpopulation (n=88), absence of bone and/or brain metastasis and presence of exon 19 EGFR M+ status at diagnosis were independently associated with longer progression-free survival (PFS) (p=0.011 and p=0.040, respectively). Conclusion: In our population, males and smokers had decreased odds of harboring an EGFR mutation, while adenocarcinoma histology was not a significant predictor of EGFR M+ status. EGFR M+ patients with bone and/or brain metastases at diagnosis or mutations other than exon 19 deletions were at increased risk for earlier disease progression. © 2018 International Institute of Anticancer Research. All rights reserved

Multiple desmoid tumors in a patient with familial adenomatous polyposis caused by the novel W421X mutation Tumor desmoide múltiple en un paciente con poliposis adenomatosa familiar originada por la nueva mutación W421X

Familial adenomatous polyposis (FAP) is a rare syndrome characterized by the presence of hundreds to thousands of colorectal adenomas and is responsible for less than 1% of all colorectal cancers. The syndrome is also characterized by extra-colorectal features including amongst others upper gastrointestinal tract polyps and desmoid tumors. The syndrome is inherited by an autosomal dominant gene, the adenomatous polyposis coli (APC) gene. We present the physical history, clinical presentation, diagnosis and treatment of a patient with a novel germline APC mutation, the W421X mutation, which resulted in FAP presenting with about a hundred colorectal polyps, gastric hyperplastic polyps and multiple aggressive intra-abdominal and extra-abdominal desmoid tumors

Lymphoepithelioma-like gastric carcinoma presenting as giant ulcer of the lesser curvature. Case report

Lymphoepithelioma-like gastric carcinoma (LELGC) has special clinicopathologic features that differentiate it from the common gastric adenocarcinoma. LELGC is a rare neoplasm of the stomach with an incidence of 1-4% of all gastric cancers and is characterized by desmoplastic stroma uniformaly infiltrated by abundant lymphocytes and plasma cells. LELGC is closely associated with the Epstein-Barr virus (EBV), with 80-100% of LELGC being EBV-positive. LELGC has a male predominance, occurs in elderly people and is usually located in the upper and middle portion of the stomach. We report a rare case of lymphoepithelioma-like gastric carcinoma located in the lesser curvature at the border of the gastric body to the pyloric antrum

Surgical Management of Severe Spontaneous Hemorrhage of the Abdominal Wall Complicating Acenocoumarol Treatment

Acenocoumarol is a vitamin K antagonist that is used for the treatment of acquired and congenital, both arterial and venous, thrombotic diseases. Its use is complicated by the narrow therapeutic range. Bleeding following oral anticoagulation, despite rare, remains the major complication. Most cases of hemorrhagic episodes usually require short hospitalization and transfusion, while surgical drainage of the hematoma is not recommended. However, in cases that conservative treatment isn’t successful, surgical intervention remains an option. We present a case of severe spontaneous bleeding of the rectus abdominis muscle which was successfully managed surgically

Mesothelial mesenteric cyst in patient with ascending colon cancer. Case report

Mesenteric cysts are rare cystic malformations of the mesentery. They are usually located at the iliac mesentery. Clinically most mesenteric cysts are asymptomatic, but sometimes they present with non-specific abdominal symptoms. Diagnosis can be aided using US, CT and MRI but careful interpretation of the images and high index of suspicion of this rare condition is essential for the correct diagnosis, which cannot always be preoperatively established. The therapeutic method of choice is complete surgical excision of the cyst which minimizes the possibility of recurrence. Histopathologically they are classified in six group. We present a case of a mesothelial mesenteric cyst in patient with colon cancer. The cyst was misdiagnosed as urinary bladder diverticulum in the preoperative CT scan

Weekly oxaliplatin (OXA), 5-fluorouracil (FU) and leucovorin (LV) as first line treatment for advanced colorectal cancer (CRC) –A phase II study

Background: OXA has previously shown high efficacy in metastatic colorectal cancer when combined with 5FU/LV, mainly as a FOLFOX schedule. This phase II clinical study was designed to evaluate the efficacy and toxicity of a different OXA-5FU/LV schedule, as first line treatment of advanced colorectal cancer. Methods: Forty-five patients with advanced CRC (median age 69 years, range 50–80, 34 males, 11 females were included. Sites of metastases included liver 25 (55.6%), lymph nodes 14 (31.1%), pelvis 12 (26.7%), peritoneum 11 (24.4%), other 9 (20.0%). Eleven patients had received prior adjuvant chemotherapy, and two radiotherapy outside of the target lesions. The regimen consisted of 200 mg/m2 LV (2h i.v.), 450 mg/m2 5-FU (bolus), and 45 mg/m2 OXA (2h i.v.), weekly for 6 weeks as induction therapy and then weekly for 3 weeks with 1 week rest until progression or unacceptable toxicity. Results: All patients were evaluable for response and toxicity. Grade 3–4 toxicities were: neurotoxicity (4%), diarrhea (4%), leucopenia (2%), nausea/vomiting (2%) and allergy (2%). Dose reductions were necessary in 14 of 45 patients (31.1%) and treatment was early interrupted in 3 of 45 patients (2 progressive disease and 1 death due to acute myocardial infarction). Complete response was observed in 4/45 (8.9%), partial response in 11/45 (24.4%) for a response rate of 33.3%. At a median follow-up of 19 months, 29 patients had relapsed (64.5%). Median time to progression was 13.4 months [95% CI: 10.6–18.2], and median survival 20.4 months [95% CI: 17.2–28.2]. Conclusions: This schedule is highly effective as first line treatment for advanced CRC. It is a feasible, well-tolerated regimen, with low incidence of G3–4 toxicities. Further evaluation is warranted. No significant financial relationships to disclose