BACKGROUND Primary splenic angiosarcoma(PSA)is an extremely rare and aggressive mesenchymal malignancy with high metastatic potential and a poor prognosis.There are no established treatment guidelines for PSA,even for...BACKGROUND Primary splenic angiosarcoma(PSA)is an extremely rare and aggressive mesenchymal malignancy with high metastatic potential and a poor prognosis.There are no established treatment guidelines for PSA,even for adjuvant therapy.This rare case may provide a reliable therapeutic regime for a better prognosis.CASE SUMMARY A 49-year-old female who complained of right-upper quadrant abdominal pain was diagnosed as having PSA with splenic rupture and liver metastasis.After splenectomy and liver tumor resection,she received sorafenib and camrelizumab therapy.After 15 mo of follow-up,she is in good condition,without recurrence or any identified metastasis.CONCLUSION Immunotherapy combined with targeted therapy could be a potential option for the adjuvant therapy of PSA.展开更多
BACKGROUND Human epidermal growth factor receptor 2(HER2)amplification is a molecular driver for a subset of colorectal cancers(CRCs)and one of the major causes of anti-epidermal growth factor receptor(EGFR)treatment ...BACKGROUND Human epidermal growth factor receptor 2(HER2)amplification is a molecular driver for a subset of colorectal cancers(CRCs)and one of the major causes of anti-epidermal growth factor receptor(EGFR)treatment failure.Compared to dual anti-HER2 treatments,which have been shown to be effective in HER2-positive metastatic CRC patients,single-agent anti-HER2 therapy is rarely used to treat CRC.CASE SUMMARY Herein,we report a case of RAS/BRAF-wild-type metastatic CRC that was identified as HER2-positive through circulating tumor DNA(ctDNA)testing by next-generation sequencing following the failure of two lines of therapy.Subsequently,the patient was given lapatinib monotherapy that led to a partial response with a progression-free survival of 7.9 mo.Moreover,serial ctDNA detection was used to monitor the efficacy of lapatinib.The aberration of HER2 copy number disappeared when radiographic assessment revealed a partial response.However,a high level of HER2 amplification was detected again at the time of disease progression.Finally,a phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha mutation was identified at the time of tumor progression,which may explain the acquired resistance to lapatinib.CONCLUSION This is the first case report of HER2-positive RAS/BRAF wild-type metastatic CRC patient responding to lapatinib monotherapy.It highlights that ctDNA testing is an effective and feasible approach to evaluate the efficacy of anti-HER2 therapy.展开更多
基金Supported by the Natural Science Foundation of Jiangxi Province (No. 20192BAB215012 and No. 20212BAB206027)the Health Commission of Jiangxi Province (No. 20203206)
文摘BACKGROUND Primary splenic angiosarcoma(PSA)is an extremely rare and aggressive mesenchymal malignancy with high metastatic potential and a poor prognosis.There are no established treatment guidelines for PSA,even for adjuvant therapy.This rare case may provide a reliable therapeutic regime for a better prognosis.CASE SUMMARY A 49-year-old female who complained of right-upper quadrant abdominal pain was diagnosed as having PSA with splenic rupture and liver metastasis.After splenectomy and liver tumor resection,she received sorafenib and camrelizumab therapy.After 15 mo of follow-up,she is in good condition,without recurrence or any identified metastasis.CONCLUSION Immunotherapy combined with targeted therapy could be a potential option for the adjuvant therapy of PSA.
文摘BACKGROUND Human epidermal growth factor receptor 2(HER2)amplification is a molecular driver for a subset of colorectal cancers(CRCs)and one of the major causes of anti-epidermal growth factor receptor(EGFR)treatment failure.Compared to dual anti-HER2 treatments,which have been shown to be effective in HER2-positive metastatic CRC patients,single-agent anti-HER2 therapy is rarely used to treat CRC.CASE SUMMARY Herein,we report a case of RAS/BRAF-wild-type metastatic CRC that was identified as HER2-positive through circulating tumor DNA(ctDNA)testing by next-generation sequencing following the failure of two lines of therapy.Subsequently,the patient was given lapatinib monotherapy that led to a partial response with a progression-free survival of 7.9 mo.Moreover,serial ctDNA detection was used to monitor the efficacy of lapatinib.The aberration of HER2 copy number disappeared when radiographic assessment revealed a partial response.However,a high level of HER2 amplification was detected again at the time of disease progression.Finally,a phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha mutation was identified at the time of tumor progression,which may explain the acquired resistance to lapatinib.CONCLUSION This is the first case report of HER2-positive RAS/BRAF wild-type metastatic CRC patient responding to lapatinib monotherapy.It highlights that ctDNA testing is an effective and feasible approach to evaluate the efficacy of anti-HER2 therapy.
