Gallbladder cancer with EGFR mutation and its response to GemOx with erlotinib: a case report and review of literature.
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Deoxycytidine
/ analogs & derivatives
ErbB Receptors
/ genetics
Erlotinib Hydrochloride
Female
Gallbladder Neoplasms
/ drug therapy
Humans
Lung Neoplasms
/ drug therapy
Middle Aged
Mutation
Oxaliplatin
/ therapeutic use
Prognosis
Protein Kinase Inhibitors
/ therapeutic use
Quinazolines
/ therapeutic use
Treatment Outcome
Gemcitabine
Chemotherapy
Erlotinib
Gallbladder cancer
Gemcitabine
Tyrosine kinase inhibitors
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
04 Jul 2020
04 Jul 2020
Historique:
received:
21
05
2020
accepted:
23
06
2020
entrez:
6
7
2020
pubmed:
6
7
2020
medline:
15
5
2021
Statut:
epublish
Résumé
Gallbladder cancer (GBC) is the most common and aggressive extra hepatic biliary tree cancer (BTC) with dismal outcome. Complete surgical resection is the treatment of choice. Chemotherapy is used for palliation in advanced GBC where surgery is not possible, and the most commonly used agent is gemcitabine in combination with cisplatin or oxaliplatin or with capecitabine regimens. Complete remissions are hardly encountered in these cases; therefore, it is important to combine standard therapies with molecular targeting. A 60-year-old woman presented with pain in abdomen and loss of appetite for 1 month, and imaging showed locally advanced gallbladder carcinoma with liver metastasis. After biopsy confirmation, patient was initially started on gemcitabine and oxaliplatin combination followed by gene sequencing, which showed Tp53 (exon 7-c.713 G > A and exon 5-c.376-2A > G) and EGFR (exon 20-T790M) mutation, and erlotinib was added to chemotherapy, after 6 cycles of chemotherapy patient showed a 90% partial radiological response as per RECIST criteria. This case reports the possible efficacy of erlotinib in combination with gemcitabine and oxaliplatin in treating an EGFR-mutated GBC with liver metastasis. To our knowledge, this is the first article reporting the response to erlotinib combination therapy with this particular solitary mutation.
Sections du résumé
BACKGROUND
BACKGROUND
Gallbladder cancer (GBC) is the most common and aggressive extra hepatic biliary tree cancer (BTC) with dismal outcome. Complete surgical resection is the treatment of choice. Chemotherapy is used for palliation in advanced GBC where surgery is not possible, and the most commonly used agent is gemcitabine in combination with cisplatin or oxaliplatin or with capecitabine regimens. Complete remissions are hardly encountered in these cases; therefore, it is important to combine standard therapies with molecular targeting.
CASE PRESENTATION
METHODS
A 60-year-old woman presented with pain in abdomen and loss of appetite for 1 month, and imaging showed locally advanced gallbladder carcinoma with liver metastasis. After biopsy confirmation, patient was initially started on gemcitabine and oxaliplatin combination followed by gene sequencing, which showed Tp53 (exon 7-c.713 G > A and exon 5-c.376-2A > G) and EGFR (exon 20-T790M) mutation, and erlotinib was added to chemotherapy, after 6 cycles of chemotherapy patient showed a 90% partial radiological response as per RECIST criteria.
CONCLUSION
CONCLUSIONS
This case reports the possible efficacy of erlotinib in combination with gemcitabine and oxaliplatin in treating an EGFR-mutated GBC with liver metastasis. To our knowledge, this is the first article reporting the response to erlotinib combination therapy with this particular solitary mutation.
Identifiants
pubmed: 32622356
doi: 10.1186/s12957-020-01934-4
pii: 10.1186/s12957-020-01934-4
pmc: PMC7335444
doi:
Substances chimiques
Protein Kinase Inhibitors
0
Quinazolines
0
Oxaliplatin
04ZR38536J
Deoxycytidine
0W860991D6
Erlotinib Hydrochloride
DA87705X9K
EGFR protein, human
EC 2.7.10.1
ErbB Receptors
EC 2.7.10.1
Gemcitabine
0
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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