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Long-term response with everolimus for metastatic renal cell carcinoma refractory to sunitinib-sorafenib sequence

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Kardas J., Buraczewska A.
OncoReview
|
2015
|
vol. 5
|
issue 2
A71-75
EN
We presented a 39-year-old male who developed progressive cancer disease 4 years after nephrectomy due to clear cell carcinoma. He was diagnosed with locally reccurence and metastases to the liver, spleen and abdominal muscles. The patient was treated with sunitinib and then after disease progression – with sorafenib. We observed 18 months of cancer control (TKI-TKI). After second progression everolimus was administered. Third line everolimus therapy helped to achieve durable stable disease with PFS 46 months till now (May 2015). The patient remains in very good performance status with minimal toxicity from the regimen. This case illustrates a long term survival for patients with metastatic renal cell carcinoma, a malignancy with historically poor prognosis. The use of three sequential targeted therapies (TKI – TKI – mTORi) helped to achieve over 5 years or disease control, with rarely seen long-term response to third line treatment (mTORi) – where stabilization is good enough. We discussed therapeutic strategies in metastatic renal cell carcinoma according to the literature and therapeutic possibilities in Poland.
2
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Everolimus-induced interstitial lung disease in patient with metastatic renal cell carcinoma – case report and literature review

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Buraczewska A., Kardas J.
OncoReview
|
2015
|
vol. 5
|
issue 3
A117-121
EN
We present a case of a 70-year-old man with metastatic renal cell carcinoma treated with second-line everolimus after rapid progression on first-line tyrosine kinase inhibitor, in whom a side effect of the therapy occurred in the form of a drug-induced interstitial lung disease. We also provide a review of the literature concerning opinions on incidence, clinical picture, consequences and management of the complication discussed.
3
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Maintenance chemotherapy with pemetrexed in patients with malignant pleural mesothelioma – case series and review of the literature

100%
Kardas J., Buraczewska A.
OncoReview
|
2016
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vol. 6
|
issue 3
A128-133
EN
Malignant pleural mesothelioma is a rare neoplasm with poor prognosis. Surgical complete resection, which is the only radical therapy available, is only possible in a minority of patients who suffer from a locally advanced disease. Radiotherapy can be considered as an adjuvant therapy after surgery or as supportive treatment in palliative care. Attempts are also made at combining it with chemotherapy. In cases of locally advanced, non-resectable or metastatic disease, chemotherapy remains the treatment of choice. The most effective palliative chemotherapy is the pemetrexed plus cisplatin regimen. We describe 3 cases of patients who underwent standard palliative chemotherapy with pemetrexed and cisplatin, manifesting good radiological and clinical response, followed by maintenance therapy with pemetrexed. The use of pemetrexed maintenance therapy helped achieve many years of disease control with acceptable toxicity. The consecutive stages of therapy were continuously discussed with our patients, and their informed consent was obtained. Pemetrexed maintenance therapy is not a standard procedure, but recent findings suggest it may be an efficacious option to consider in selected groups of patients. Further randomized prospective studies are needed, but a limiting factor is the rarity of the disease.
4
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Papillary renal cell carcinoma – case report of a patient with disseminated disease treated with pazopanib with several years of survival against reviewing current literature

100%
Buraczewska A., Kardas J.
OncoReview
|
2016
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vol. 6
|
issue 2
A62-65
EN
Papillary renal cell carcinoma is the second most common histological type of renal cell carcinoma with distinct cytogenetics, histology and prognosis. It exhibits significantly poorer response to molecular targeted therapies, which are about the progress in clear cell carcinoma. We present an overview of the treatment trials and report a casuistic case of metastatic disease controlled for several years with pazopanib.
5
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Hypothyroidism caused by cabozantinib therapy of clear cell renal cell carcinoma – case report, own experience

71%
Buraczewska A., Kardas J., Młot B., Solarek W., Waśko-Grabowska A.
OncoReview
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2017
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vol. 7
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issue 3
121-125
EN
Cabozantinib, the latest available in Poland medication for the treatment of renal cell carcinoma, registered in this indication by the European Medicines Agency (EMA) in September 2016, has been available in several cancer centers in Poland since November 2016 as part of the expanded access program. Primary hypothyroidism is a common complication during thyrosine kinase inhibitors (TKI) treatment, although there are few reports of its occurrence during treatment with cabozantinib, which belongs to this medication group. We present a case of rapid development of clinically apparent hypothyroidism after cabozantinib treatment and report data on this complication in the group of our patients.
6
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The evaluation of the efficacy and toxicity of targeted treatment in non-small cell lung cancer patients – single centre experience

61%
Kardas J., Buraczewska A., Chrom P., Waśko-Grabowska A., Młot B., Szczylik C.
OncoReview
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2017
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vol. 7
|
issue 2
92-97
EN
Introduction: Tyrosine kinase inhibitors (TKI) are the standard of treatment in patients with advanced non-small cell lung cancer (NSCLC) with EGFR (endothelial growth factor receptor) gene activating mutation. Objective: The evaluation of the efficacy and toxicity of TKI drugs in NSCLC patients treated in single centre. Material and methods: NSCLC patients treated with TKI (gefitinib, erlotynib, afatinib) between 2012– 2016 were retrospectively analysed. We evaluated: overall response rate (ORR) which is the sum of complete responses (CR) and partial remissions (PR), progression free survival (PFS), overall survival (OS) and adverse events (AE) according to CTCAE (Common Terminology Criteria for Adverse Events) scale. Results: The study group were 16 patients ORR was 50% (CR: 1, PR: 7). Median PFS and OS was 8,7 and 22,9 months respectively. Adverse events observed mainly in stage 1 and 2 were related to hyponatraemia, hyperbilirubinemia, skin toxicity and mucositis. There was one death reported due to infectious complications. Conclusion: The efficacy and toxicity of TKI in study group were found to be similar to those described in the literature.
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