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P. Szlezak

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    P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P1.01-024 - Case Report of a Patient with Non-Small Cell Cancer Treated in Two Consecutive Randomized Clinical Trilas. Safety of Imaging Procedures (ID 787)

      09:30 - 17:00  |  Author(s): P. Szlezak

      • Abstract
      • Slides

      Severala rates for patients with adenocarcinoma of the lung who cannot be treated with targeted therapies due to lack of EGFR gene mutation or EML4-ALK translocation are relatively poor. Clinical trials with a new compounds pose a chance to improve treatment outcome, but also expose patients to many additional and potentially risky-related diagnostic procedures

      Case study analysis of 57 - years old male patient diagnosed in 2008 with metastatic adenocarcinoma of lung cT2N0M1. Patient was in good condition without any significant comorbidities.Patient has been qualified to A6181058 clinical trial- he received 6 cycles of Paclitaxel and Carboplatin chemotherapy with subsequent maintenance therapyconsisting of 72 Bevacizumab infusions.Partial remission has been achived with reduction of tumor size by 60%. Subsequently, due to disease progression, patient have been enrolled into another clinical trial - EC-FV-07 - 9 cycles of Docetaxel and 26 injections of folate receptor inhibitor EC145 has been applied. After 71 months since treatment initiationdisease has progressed.Upon disease progression paliative radiotherapy has been started. During treatment period, because of clinical trial scheduling requirements, contrast-enhanced computed tomography ( CE-CT)scans were performed every 6 to 8 weeks. During whole disease course neither lung cancer itselfnor applied treatment did not impaire patient's daily activity. Aim of this report is to analyse a disease course and risks of repeated contrast enhanced computed tomography in patient treated with potentially nepfotoxic drug with long lasting maintenace treatment.

      During seven years of treatment contrast-enhanced chest CT scans has been performed 57 times. Effective radiation dose patient has received was 395mSv and 4560 mg of iodine-based contrast was injected.Cumulative doses of chemotherapeutic agents was as folows- Bevacizumab -87480 mg; EC145(Vintafolide) - 90 mg, Carboplatin 3700 mg, Paclitaxel -2508 mg, Docetaxel -1710 mg. Baseline renal function described by glomerular filtration rate (GFR) was 78 ml/min and during treatment GFR never dropped below ml/min. Patient developped sensory peripheral neuropathy, CTC grade 2.Use of ACE inhibitor therapy due to arterial hypertension has been initiated.No other clinically significant toxicity has been observed, including myelotoxicity and renal toxicity other than non-significant transient proteinuria.

      By presenting this case report we would like to bring attention to long -term survival in patient with metastatic NSCLC treated with two lines of chemotherapy that included taxane and targeted molecular therapy. Despite potentially nephrotoxic regimens and rigorous iodine- based CT disease monitoring scans no significant toxicity has been observed. A matter of discussion is a significance of ACE inhibitor for renal protection in contrast-and chemotherapy -induced toxicity.

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