Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report.
Case report
Chemotherapy
Clear cell adenocarcinoma
Genetic testing
Oncology
Personalized
Urethra
Journal
World journal of clinical oncology
ISSN: 2218-4333
Titre abrégé: World J Clin Oncol
Pays: United States
ID NLM: 101549149
Informations de publication
Date de publication:
24 Apr 2020
24 Apr 2020
Historique:
received:
08
12
2019
revised:
06
03
2020
accepted:
12
03
2020
entrez:
2
5
2020
pubmed:
2
5
2020
medline:
2
5
2020
Statut:
ppublish
Résumé
Clear cell adenocarcinoma of the urethra is a rare type of aggressive cancer with a poor prognosis. Clear cell carcinoma of the urethra represents less than 0.02% of all malignancies in women. Adenocarcinomas account for 10% of female urethral carcinomas, of which 40% are the clear cell variant. Determining the presence or absence of certain mutations through genetic testing may predict whether a patient with cancer may benefit from a particular chemotherapy regimen. A 40-year-old woman presented with a 3-year history of slow urinary flow and a 3-mo history of urinary urgency and frequency as well as gross hematuria. An abdominal and pelvic computed tomography scan demonstrated enlarged lymph nodes in the abdomen and pelvis. A biopsy of a left inguinal lymph node microscopically confirmed a metastatic adenocarcinoma of the urethra. Specialized genetic testing determined personalized chemotherapy. She was treated successfully with a non-platinum-based chemotherapy consisting of paclitaxel and bevacizumab. Following 3 cycles of paclitaxel and bevacizumab, she attained significant clinical improvement, and response by FDG-Positron emission tomography (PET) imaging showed a definite improvement in size and metabolic activity. She achieved complete response after 6 cycles of therapy by PET scan. The patient concluded 11 cycles of paclitaxel and bevacizumab, and a subsequent PET scan confirmed progression of metastatic disease. The patient was then treated with two cycles of doxorubicin after which a PET scan revealed a mixed response to the treatment. We report the first case of a patient with metastatic clear cell adenocarcinoma of the urethra who underwent personalized chemotherapy after testing for cancer gene alterations. Our unique case represents the safe and effective use of non-platinum-based chemotherapy in clear cell adenocarcinoma of the urethra.
Sections du résumé
BACKGROUND
BACKGROUND
Clear cell adenocarcinoma of the urethra is a rare type of aggressive cancer with a poor prognosis. Clear cell carcinoma of the urethra represents less than 0.02% of all malignancies in women. Adenocarcinomas account for 10% of female urethral carcinomas, of which 40% are the clear cell variant. Determining the presence or absence of certain mutations through genetic testing may predict whether a patient with cancer may benefit from a particular chemotherapy regimen.
CASE SUMMARY
METHODS
A 40-year-old woman presented with a 3-year history of slow urinary flow and a 3-mo history of urinary urgency and frequency as well as gross hematuria. An abdominal and pelvic computed tomography scan demonstrated enlarged lymph nodes in the abdomen and pelvis. A biopsy of a left inguinal lymph node microscopically confirmed a metastatic adenocarcinoma of the urethra. Specialized genetic testing determined personalized chemotherapy. She was treated successfully with a non-platinum-based chemotherapy consisting of paclitaxel and bevacizumab. Following 3 cycles of paclitaxel and bevacizumab, she attained significant clinical improvement, and response by FDG-Positron emission tomography (PET) imaging showed a definite improvement in size and metabolic activity. She achieved complete response after 6 cycles of therapy by PET scan. The patient concluded 11 cycles of paclitaxel and bevacizumab, and a subsequent PET scan confirmed progression of metastatic disease. The patient was then treated with two cycles of doxorubicin after which a PET scan revealed a mixed response to the treatment.
CONCLUSION
CONCLUSIONS
We report the first case of a patient with metastatic clear cell adenocarcinoma of the urethra who underwent personalized chemotherapy after testing for cancer gene alterations. Our unique case represents the safe and effective use of non-platinum-based chemotherapy in clear cell adenocarcinoma of the urethra.
Identifiants
pubmed: 32355644
doi: 10.5306/wjco.v11.i4.243
pmc: PMC7186237
doi:
Types de publication
Case Reports
Langues
eng
Pagination
243-249Informations de copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Références
Int J Cancer. 2009 Feb 15;124(4):806-15
pubmed: 19035454
Urol Oncol. 2013 Oct;31(7):1171-7
pubmed: 22534087
Int J Gynecol Cancer. 2009 Jul;19(5):820-5
pubmed: 19574766
Radiol Case Rep. 2015 Nov 06;6(3):490
pubmed: 27307909
Am J Pathol. 2014 Mar;184(3):584-91
pubmed: 24389164
Ann Surg Oncol. 2001 Jan-Feb;8(1):72-9
pubmed: 11206229
Int J Gynecol Cancer. 2007 Jan-Feb;17(1):76-82
pubmed: 17291235
Int J Surg Oncol. 2015;2015:790235
pubmed: 25685552
Mol Cancer. 2009 Jul 14;8:48
pubmed: 19602291
J Cancer Res Ther. 2018 Jan-Mar;14(2):468-470
pubmed: 29516944
Clin Cancer Res. 1999 Aug;5(8):2048-58
pubmed: 10473085
Eur Urol. 2013 Nov;64(5):823-30
pubmed: 23582479
J Urol. 2001 Nov;166(5):1759-61
pubmed: 11586218
Clin Cancer Res. 2008 Sep 15;14(18):5893-9
pubmed: 18794102
Nature. 2005 Apr 14;434(7035):917-21
pubmed: 15829967
Cell. 2012 Feb 3;148(3):409-20
pubmed: 22304912
AJR Am J Roentgenol. 2017 Apr;208(4):805-811
pubmed: 28140610
Mol Cancer Ther. 2004 Oct;3(10):1207-14
pubmed: 15486187
Virchows Arch. 2013 Feb;462(2):193-201
pubmed: 23307189
Clin Cancer Res. 2007 Dec 15;13(24):7413-20
pubmed: 18094425
N Engl J Med. 2006 Sep 7;355(10):983-91
pubmed: 16957145
J Urol. 2008 Feb;179(2):536-41; discussion 541
pubmed: 18076921
Mod Pathol. 1996 May;9(5):513-20
pubmed: 8733766
Int J Urol. 2003 Jun;10(6):348-9
pubmed: 12757608
J Urol. 2008 Dec;180(6):2656
pubmed: 18951583
Urol Int. 2017;99(4):487-490
pubmed: 26807736
Urology. 1998 Sep;52(3):487-93
pubmed: 9730466