Typowe działania niepożądane u pacjentki leczonej lapatynibem z kapecytabiną z powodu rozsianego raka piersi

Nadmierna ekspresja receptora HER2 u chorych na raka piersi występuje u około 20% pacjentów i stanowi niekorzystny czynnik rokowniczy [1]. Wprowadzenie terapii celowanej wpłynęło na poprawę rokowania w tej grupie chorych [2–6]. Obecnie po niepowodzeniu leczenia trastuzumabem u chorych na rozsianego raka piersi stosuje się lapatynib w skojarzeniu z kapecytabiną. W trakcie długotrwałego leczenia paliatywnego ważne jest monitorowanie profilu toksyczności. W niniejszym opisie przedstawiono przypadek chorej, u której w trakcie leczenia lapatynibem w skojarzeniu z kapecytabiną obserwowano typowe dla tego schematu terapii działania niepożądane

The analysis of the prognostic value of the neutrophil/ lymphocyte ratio and the platelet/lymphocyte ratio among advanced endometrial cancer patients

Objectives: About 20% of endometrial cancer (EC) patients have advanced disease (FIGO III & IV) at the moment of diagnosis.An attempt to evaluate the prognostic value of biochemical markers of inflammation and classic endometrial cancerprognostic factors in the group of advanced EC (aEC) patients has been made in this study.Material and methods: Records of 266 patients treated in the Maria Sklodowska-Curie Memorial Cancer Centre and Instituteof Oncology, Cracow Branch between the year 2006 and 2018 were included in the study. Follow-up ranged from 1 to138 months. Progression free survival (PFS) and overall survival (OS) have been set as endpoints. Tests such as: chi-squared,Fisher, log-rank, Mann-Whitney, Kruskal-Wallis and Cox proportional hazard ratio were used in the statistical analyses.Results: In the analysed group high total platelet count (PLT) before operative treatment and high levels of white blood cells(WBC), PLT, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) before adjuvant therapy (AT) have beensignificantly associated with shorter PFS and OS. After setting the cut-off values of NLR and PLR a statistically significantcorrelation between those parameters and PFS as well as OS has been shown. Multivariate analysis has indicated that NLRis an independent prognostic factor of the course of aEC.Conclusions: NLR and PLR correlate significantly with OS and PFS in aEC. NLR is an independent prognostic factor in thisgroup. It is possible to distinguish 3 risk groups, among aEC patients, based on NRL and PLR

Eosinophilic ascites: a case report and literature review

Ascites with elevated serum CA-125 but without suspicious adnexal masses is a diagnostic challenge. The differential diagnosis of patients aged 20–50 years old presenting with ascites should account for rare etiologies, such as the hypereosinophilic syndrome. A 37-year-old patient was referred to the Gynecologic Oncology Outpatient Clinic of the University Hospital in Krakow due to rapidly progressing ascites with serum CA-125 above the normal limit. Thorough imaging studies showed no evidence of malignant ascites, whilst hypereosinophilia was detected in laboratory tests. After ruling out other causes of primary and reactive hypereosinophilia, the diagnosis of the hypereosinophilic syndrome was made. After the administration of oral corticosteroid therapy, complete resolution of symptoms (including ascites) was achieved, and CA-125 level returned to normal. Currently, the patient is asymptomatic and is followed up at the Autoimmune Diseases Outpatient Clinic.Wodobrzusze z towarzyszącą antygenemią CA-125 przy jednoczesnym braku onkologicznie podejrzanych zmian w obrębie jajnika jest trudnym problemem diagnostycznym. W toku diagnostyki różnicowej u pacjentek pomiędzy 20. a 50. rokiem życia z wodobrzuszem, aby uniknąć niepotrzebnej interwencji chirurgicznej, należy wziąć pod uwagę rzadkie przyczyny tego objawu, m.in. zespół hipereozynofilowy. Trzydziestosiedmioletnia pacjentka została skierowana do Poradni Ginekologii Onkologicznej Szpitala Uniwersyteckiego w Krakowie z powodu szybko narastającego wodobrzusza z towarzyszącym wzrostem stężenia markera CA-125 powyżej wartości referencyjnych. W szczegółowej diagnostyce obrazowej wykluczono nowotworowe pochodzenie wodobrzusza, a laboratoryjnie stwierdzono hipereozynofilię. Po wykluczeniu innych przyczyn eozynofilii pierwotnej i reaktywnej rozpoznano zespół hipereozynofilowy. Po włączeniu steroidoterapii doustnej zaobserwowano całkowite ustąpienie objawów (w tym wodobrzusza) i unormowanie stężenia CA-125. Obecnie pacjentka nie ma żadnych objawów, pozostaje pod opieką Poradni Chorób Immunologicznych

Assessment of frequency and severity of hypomagnesemia in patients with metastatic colorectal cancer treated with cetuximab, with a review of the literature

Currently, there are a few systemic treatment options for patients with metastatic colorectal cancer (mCRC). Targeted therapy used in this setting includes the use of monoclonal antibodies, such as cetuximab or panitumumab, directed against epidermal growth factor receptor. The aim of the present study was to estimate the frequency and severity of hypomagnesemia among patients with mCRC treated with cetuximab. The data from the Department of Clinical Oncology, University Hospital of Krakow (Krakow, Poland), concerning 52 patients treated between 2009 and 2013 were collected. Of these, 27 patients fulfilled the inclusion criteria to enter this retrospective study. The National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 were used to grade the level of hypomagnesemia. In total, 29.6% of all patients experienced hypomagnesemia during treatment, and the majority of cases were grade 1 (22.2%). There was no statistically significant correlation between magnesium (Mg) level and patient age, duration of treatment, localization of primary tumor or metastases, and the number of metastases. However, there was an upward trend in a logistic regression model showing that the risk of developing hypomagnesemia increases with age. Hypomagnesemia is a frequent problem among mCRC patients receiving cetuximab. It is essential to introduce guidelines regarding the monitoring of the Mg level and its supplementation in this group of patients