Combination of radiotherapy and Nimotuzumab in a patient with brain metastasis
Keywords:
LUNG NEOPLASMS, NEOPLASM METASTASIS, RADIOTHERAPY/adverse effects.Abstract
Lung cancer is the main cause of death because of cancer all over the world. The 80 % belong to non-small cell lung cancer and the 70 % are diagnosed with locally advanced or metastatic disease. The brain metastases are present in 20 to 30 % of patients at the moment of diagnosing, with an average of survival without treatment of 4 months. This is a case of a 53-year-old patient with a history of hypertension, being a heavy smoker, who was studied in the internal medicine service for presenting neurological symptoms, undergoing the appropriate studies and being diagnosed with a non-small cell lung cancer with brain metastasis. He was assessed at the oncology central consultation office, being classified as T2a N2 M1b, stage IV and was proposed to be included in the clinical trial "Using the monoclonal antibody hR3 and radiotherapy in the treatment of patients with non-small cell lung cancer carriers of brain metastasis", being indicated chemotherapy + radiotherapy and monoclonal antibody Nimotuzumab, following this treatment up today, emphasizing the positive clinical and imaging response to treatment, with a patients’ survival higher than the one reported in the specialized literature and a good quality of life.
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Akashi Y, Okamoto T, Iwasa T, Yoshida T, Suzuki M, Hatashita E. Enhancement of the antitumor activity of ionising radiation by Nimotuzumab, a humanised monoclonal antibody to the epidermal growth factor receptor, in non-small cell lung cancer cell lines of differing epidermal growth factor receptor status. Br J Cancer [revista en internet]. 2008 [citado 29 de octubre 2015]; 98: 749-55. Disponible en: http://www.nature.com/bjc/journal/v98/n4/abs/6604222a.html.
Ministerio de Salud Pública. Anuario Estadístico de Salud 2014 [en línea]. Cuadro 44. La Habana; 2015. p. 66 [citado 29 de octubre 2015]. Disponible en: http://files.sld.cu/bvscuba/files/2015/04/anuario-estadistico-de-salud-2014.pdf.
M. Reck, S. Popat, N. Reinmuth, et al. Metastatic non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology [revista en internet]. 2014 [citado 29 de octubre 2015]; 199: 1–13. Disponible en: http://annonc.oxfordjournals.org/content/early/2014/08/11/annonc.mdu199.short.
Jemal A, Siegel R, Xu J, Ward E. Cancer statistics. CA Cancer J Clin [revista en internet]. 2010 [citado 29 de octubre 2015]; 60(5): 277–300. Disponible en: http://onlinelibrary.wiley.com/doi/10.3322/caac.20073/pdf.
Athanasios G. Pallis, Kostas Syrigos. Targeted (and chemotherapeutic) agents as maintenance treatment in patientswith metastatic non-small-cell lung cancer: Current status and future challenges. Cancer Treat Reviews [revista en internet]. 2012 [citado 29 de octubre 2015]; 38(7): 861–867. Disponible en: http://www.sciencedirect.com/science/article/pii/S0305737211002556.
Custodio A, Mendez M, Provencio M. Targeted therapies for advanced non-small-cell lung cancer: Current status and future implications. Cancer Treatment Reviews [revista en internet]. 2012 [citado 29 de octubre 2015]; 38(1): 36–53. Disponible en: http://www.sciencedirect.com/science/article/pii/S0305737211000636.
Barker AJ, Gibson KH, Grundy W, Godfrey AA, Barlow JJ, Healy MP, et al. Studies leading to the identification of ZD1839 (IRESSA): an orally active, selective epidermal growth factor receptor tyrosine kinase inhibitor targeted to the treatment of cancer. Bioorg Med ChemLett [revista en internet]. 2001 [citado 29 de octubre 2015]; 11(14): 1911-4. Disponible en: http://www.sciencedirect.com/science/article/pii/S0960894X01003444.
Norman P. OSI-774 OSI Pharmaceuticals. Curr Opin Investig Drugs [revista en internet]. 2001 [citado 29 de octubre 2015]; 2(2): 298-304. Disponible en: http://europepmc.org/abstract/med/11816847.
Hua-qing W, Yangang R, Zheng-zi Q, Kai F, Hui-lai Z, Wei Li, et al. Nimotuzumab combined with gemcitabine and cisplatin as second-line chemotherapy for advanced non-small-cell lung cancer. Thoracic Cancer [revista en internet]. 2012 [citado 29 de octubre 2015]; 3(1): 72–78. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/j.1759-7714.2011.00083.x/full.
Díaz A, Lage A. Terapias con inhibidores del receptor del factor de crecimiento epidérmico: acercando el futuro. Biotecnología Aplicada [revista en internet]. 2007 [citado 29 de octubre 2015]; 24(1): 1-9. Disponible en: http://elfosscientiae.cigb.edu.cu/PDFs/Biotecnol%20Apl/2007/24/1/BA002401RV001-009.pdf.
Vicente Pardo JM. Impacto del dolor en la incapacidad laboral. Metodología de valoración. Grados funcionales de limitación. Med Segur Trab [revista en internet]. 2014, Enero-marzo [citado 29 de octubre 2015]; 60(234): 133-142. Disponible en: http://scielo.isciii.es/pdf/mesetra/v60n234/inspeccion3.pdf.
Ramakrishnan MS, Eswaraiah A, Crombet T, Piedrac P, Saurez G, Iyer H, et al. Nimotuzumab, a promising therapeutic monoclonal for treatment of tumors of epithelial origin. MABS [revista en internet]. 2009, Enero [citado 29 de octubre 2015]; 1(1): 41-48. Disponible en: http://www.tandfonline.com/doi/abs/10.4161/mabs.1.1.7509.
Bebb G, Smith C, Rorke S, Boland W, Nicacio L, Sukhoo R., Brade A. Phase I clinical trial of the anti-EGFR monoclonal antibody nimotuzumab with concurrent external thoracic radiotherapy in Canadian patients diagnosed with stage IIb, III or IV non-small cell lung cancer unsuitable for radical therapy. Cancer Chemother. Pharmacol [revista en internet]. 2011 [citado 29 de octubre 2015]; 67(4): 837-45. Disponible en: http://link.springer.com/article/10.1007/s00280-010-1379-9.
Hye Jin Choi, Joo Hyuk Sohn, Chang Geol Lee, Hyo Sub Shim, Ik-Jae Lee, Woo Ick Yang. A phase I study of nimotuzumab in combination with radiotherapy in stagesIIB-IV non-small cell lung cancer unsuitable for radical therapy: Korean results. Lung Cancer [revista en internet]. 2011 [citado 29 de octubre 2015]; 71(1): 55-59. Disponible en: http://www.sciencedirect.com/science/article/pii/S0169500210001698.
Macias A. et al. Uso del AcM hR3 y radioterapia en el tratamiento de pacientes con cáncer de pulmón de células no pequeñas (CPCNP) portadores de metástasis cerebral. IIC RD-EC079. Informe Final. 2010.
Crombet T. et al. Programa Uso Clínico Expandido. Evaluación de la supervivencia de pacientes con tumores avanzados de pulmón de células no pequeñas tratados con el anticuerpo monoclonal anti-EGFR nimotuzumab. Informe Final. 2010.
Rodriguez MO, Rivero TC, del Castillo Bahi R, Muchuli CR, Bilbao MA, Vinageras EN, etal. Nimotuzumab plus radiotherapy for unresectable squamous-cell carcinoma of the head and neck. Cancer BiolTher [revista en la Internet] 2010 [citado 2015 Nov 19]; 9(5): 343-9. Disponible en: http://ncbi.nlm.nih.gov/pubmed/www.20448462.
Ramakrishnan MS, Eswaraiah A, Crombet T, Piedra P, Saurez G, Iyer H, et al. Nimotuzumab, a promising therapeutic monoclonal for treatment of tumors of epithelial origin. mAbs [revista en la Internet] 2009 [citado 2015 Nov 19]; 1(1):41-8. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715181/.
Saurez-Martínez Giselle, Bencomo-Yanes Anamary. Nimotuzumab, effective immunotherapy for the treatment of malignant epithelial tumors. Biotecnol Apl [revista en la Internet]. 2014 Jun [citado 2015 Nov 19]; 31(2): 159-167. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1027-28522014000200007&lng=es.
Boland W, Bebb G. The emerging role of nimotuzumab in the treatment of non-small cell lung cancer. Biologics [revista en la Internet] 2010 [citado 2015 Nov 19]; 4:289-98. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990321/.
World Health Organization [Internet]. International Clinical Trials Registry Platform (ICTRP). 2013. Geneva: WHO [citado 2015 Nov 19] Disponible en: http://www.who.int/ictrp/en/.
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