BRAF mutations are uncommon in non‐small cell lung cancer (NSCLC), accounting for less than 5% of all NSCLC cases. The utilization of targeted therapies in non‐V600E BRAF mutant NSCLC is considered controversial, although non‐V600E genotype is reported in ~50% of all BRAF mutant patients. We document the case of a 63‐year‐old patient with NSCLC harbouring a rare BRAF E501Q mutation, who had prolonged response to immunotherapy combined with chemotherapy in Vietnam. The patient was diagnosed with metastatic PD‐L1‐negative lung adenocarcinoma and received pembrolizumab plus chemotherapy as first‐line treatment. After completing 35 cycles of pembrolizumab and pemetrexed, his disease has remained stable during the treatment‐free follow‐up period, and he is alive 38 months after treatment initiation at the latest follow‐up. Immune‐based therapy is an appropriate option for lung adenocarcinoma with rare non‐V600E BRAF mutation. Further clinical studies are necessary to determine the effectiveness of using immune‐based therapy in this specific population.
A complex of
G719X
and
S768I
mutations is infrequently observed, constituting less than 0.3% of all
EGFR
‐positive non‐small cell lung cancer (NSCLC), and the response to first‐line TKIs is inconsistent in the literature. In this study, we report a patient with metastatic non‐small cell lung cancer carrying rare
EGFR
compound mutations of
G719X
and
S768I
who benefited from first‐line treatment with gefitinib in Vietnam. This patient had a prolonged response lasting over 44 months with first‐generation TKI. He continued to take gefitinib without experiencing serious adverse events. NSCLC with a rare complex of
G719X
and
S768I
mutation revealed a good response to gefitinib.
Objective
To evaluate the outcome and safety of the paclitaxel, carboplatin, and capecitabine (TCX) regimen in patients with advanced gastric cancer.
Methods
Advanced gastric cancer patients received the TCX regimen for up to six cycles, which were 3 weeks apart. Paclitaxel (175 mg/m2) was given over a 3-hour infusion, followed by carboplatin in a 1-hour infusion on day 1. Capecitabine (850 mg/m2) was given orally twice daily from day 1 to day 14. Primary endpoints were progression-free survival (PFS) and overall survival (OS).
Results
Among 83 patients at stage IVa and IVb, the median PFS was 9.3 months; 6-month, 1-year, and 2-year PFS were 74.6%, 32.5%, and 14.4%, respectively. The median OS was 17.0 months; 6-month, 1-year, and 2-year OS were 97.5%, 68.7%, and 21.7%, respectively. In the multivariable Cox regression model, higher CEA was associated with poor OS. Common adverse events included hand-food syndrome (77.9%), peripheral neuropathy (63.2%), fatigue (68.7%), and nausea (54.2%).
Conclusion
The TCX regimen provided good survival and a better safety profile. More clinical trials are needed to confirm its treatment efficacy and safety, especially in comparison with other triplet regimens.
Background: Granulosa cell tumor of the ovary is a rare disease and presents with two clinically and molecularly distinct subtypes: the juvenile and the adult type. GCT is considered as a malignant tumor with an indolent course and a tendency toward late recurrence. Purpose: To assess the clinical and paraclinical features, treatment findings, survival outcomes, and explored the prognostic factors in the granulosa cell tumor. Methods: The current study was conducted on 28 GCT patients who had surgical operations and adjuvant chemotherapy (stage IC-IV) by applying a retrospective cohort analysis. The clinical and paraclinical characteristics were recorded. Recurrent status was evaluated for analysis with clinical and paraclinical features and survival. All GCT patients’ survival were analyzed by using Kaplan-Meier and Log-Rank models. Results: 17.9% of patients experienced a relapse and two patients died due to disease. The mean time from initial diagnose to recurrence was 40.21 months. The 5-year OS and DFS of stage I-II were 100% and 80.8%, and of stage III were 50% and 25%, respectively. In survival analyses, using the log-rank test, age ≥50 years, irregular menstruation, stage I-II, and absence of residual lesion were all significant predictors for the improved DFS. Stage I-II and absence of residual lesion were associated significantly with better OS. Mean of age, FIGO stage, and residual lesion during surgery had significant differences to recurrent rate (p < <0.05). The multivariate model revealed that these factors didn’t remain as an independent prognostic variable. Conclusion: FIGO stage and residual lesion during surgery had significant differences in survival and recurrent rate.
Squamous cell carcinoma admixed with large-cell neuroendocrine carcinoma of the uterine cervix is an extremely rare malignancy with a poor prognosis. We report a 50-year-old woman with mixed squamous cell carcinoma and large-cell neuroendocrine carcinoma of the uterine cervix with an individual history of early-stage breast cancer. She was diagnosed preoperatively with cervical cancer stage FIGO 1B2. However, during surgery, a lesion was found in Douglas’s peritoneum. The histopathological result of surgical specimens was mixed squamous cell carcinoma and large-cell neuroendocrine carcinoma. Then, she received concurrent chemoradiotherapy. Currently, after 3 months of treatment, she has not developed recurrent lesions.
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