Impressive objective response to nab-paclitaxel plus trastuzumab as fifth line therapy in aelderly her2-positive breast cancer patient

Agent targeting HER-2 pathway plus chemotherapy has represented a major progress in the management of patients with breast cancer. However the role of late-line treatment in heavily pretreated patients is largely unclear. In the last decade nab-paclitaxel has show significant activity and good toxicity profile in metastatic breast cancer. We report the case of a 76-year-old Caucasian woman with metastatic HER-2 positive ductal infiltrating breast carcinoma treated with a combination of weekly nab-paclitaxel and trastuzumab as fifth-line therapy. She had previously received first-line paclitaxel and trastuzumab, second-line vinorelbine and trastuzumab, third-line TDM1 and fourth-line oral ca…

I tumori stromali gastrointestinali: presentazione di sei casi e revisione della letteratura

Gastrointestinal stromal tumours (GISTs) represent the most common kind of mesenchymal tumours that arise from the alimentary tract. GISTs express a growth factor receptor with tyrosine kinase function, which causes cellular proliferation and resistance to apoptosis. GISTs are generally found in the stomach (40-70%), and less commonly in the small intestine, colon-rectum, esophagus and peritoneum. Clinical and instrumental diagnosis is still very difficult to make. Surgery remains the standard treatment for nonmetastatic tumours. For non resectable and metastatic tumours seems to be effective the therapy with Imatinib mesylate, a specific inhibitor of tyrosine kinase receptor (KIT). Are ong…

PULMONARY EMBOLISM IN AN EMERGENCY CARE UNIT: EVALUATION OF PREDICTIVE FACTORS FROM CLINICAL HISTORY AND PHYSICAL EXAM

Objective: An early diagnosis of pulmonary embolism (PE) improves outcome. Therefore, PE should be diagnosed in Emergency Care Units (ECU) at admission. Clinical algorithms support the clinician in this task, although performance is biased by differences in risk factors prevalent in different populations. The clinical conditions predictive of PE were evaluated in subjects from Southern Italy accessing ECU for dyspnea/chest pain.Methods: Retrospective clinical data were obtained by electronic retrieving from a hospital database. Data from 8177 patients (age 18-90 years, 54 with PE) were collected from years 2007-2013.Results: Previous history of PE, thrombosis and/or phlebitis, rheumatic dis…

Lapatinib activity in a patient with encephalic metastases from trastuzumab-resistant her-2 positive breast cancer

A 42-year-old woman with right breast cancer cT4dN2M0 HR +, HER2 +, undergoes mastectomy with axillary lymphadenectomy after neoadjuvant chemotherapy. During adjuvant treatment with trastuzumab and hormone therapy, the patient develops multiple symptomatic encephalic metastases. She undergoes panencephalic radiotherapy and begins chemotherapy with capecitabine and lapatinib. After three months of well tolerated therapy, an important volumetric response of encephalic metastases is observed, with regression of neurological symptoms.

Gastric metastasis from breast cancer

Introduction: Breast carcinoma is the most common malignancy in women and the main cause of tumor deaths. Despite early recognition by screening and improvement in treatment regimens, many patients will eventually develop metastases, either locoregional recurrences or distant metastases, most frequently in the skeleton, liver and lung. Metastases to the gastrointestinal tract are infrequent and not even mentioned in the major oncologic textbooks. Case presentation: We report a case of metastasis to the stomach from occult breast cancer. The diagnosis was established by computed tomography (CT), histologic and immunohistochemical analyses of biopsies of the stomach lesion. The patient was tr…

Tattica chirurgica nel trattamento delle neoplasie maligne della tiroide