Abstract YO28P
Case summary
ATC is an undifferentiated tumour and lethal. Conventional treatment has not demonstrated clear therapeutic efficacy in prolonging the survival in metastatic ATC. There are growing interest in the new molecular targeted therapies. We present the case of a patient with metastatic ATC who had a good response to ALK inhibitor.
The patient was a 44 years old woman who presented with the left neck swelling for two months that had progressed rapidly to the bilateral neck swelling, the axillary swelling and subsequently to an episode of seizure.
The CT brain showed a focal enhancing brain lesion at the left frontal lobe measuring 25x18mm. The positron emission tomography (PET) scan demonstrated metabolic active diseases at the thyroid gland, left frontal lobe of cerebrum, left lower lobe of lung and multiple nodal metastasis.
The histopathology of the right cervical lymph node biopsy showed metastatic carcinoma. Immunohistochemistry staining were positive for TTF-1, p40, p63, and thyroglobulin but were negative for CD30, Napsin A, BCL-2 and EBV-LMP-1. Based on all the findings stage IVC ATC was diagnosed.
The patient had a stereotactic radiosurgery (SRS) to the brain lesion. An extended NGS panel showed positive result for ALK-EML4 mutation. She was started on 250mg BD of the crizotinib and had noticed reduction in the size of the cervical node swelling however the treatment was then stopped as she developed crizotinib induced interstitial pneumonitis.
Ceritinib was started on the 9th November 2018. The cervical node swelling noticeably became smaller fourteen days later. Her condition remained stable during the subsequent clinics follow up.
A scheduled CT scan was performed at six months post treatment and showed a new metastatic deposit at right lower lobe lung nodule (1.4cm) with smaller and stable disease elsewhere. She had a radiofrequency ablation (RFA) to the right lower lung nodule, and the ceritinib was continued. She remained clinically stable to date.
ALK inhibitor was effective in controlling the disease in this patient with estimated progression free survival of approximately six months with the good quality of life. Molecular targeted therapy could be a new way forward in managing metastatic ATC.
Clinical trial identification
Editorial acknowledgement
Resources from the same session
184P - Expression pattern of CDK12 protein in gastric cancer and its positive correlation with CD8+ cell density and CCL12 expression
Presenter: Jun Ji
Session: Poster display session
Resources:
Abstract
185P - Evaluation of the effect of cholesorption on the concentration of TNF-α in the serum of the blood in tumours of the biliopancreatoduodenal zone
Presenter: Marufjon Salokhiddinov
Session: Poster display session
Resources:
Abstract
186P - Efficacy and safety of sorafenib following hepatic resection in patients with hepatocellular carcinoma: A meta-analysis
Presenter: Yang Yuan
Session: Poster display session
Resources:
Abstract
187P - Correlation between spleenic dose and grade of hematological toxicity in chemoradiation of stomach
Presenter: Umesh Velu
Session: Poster display session
Resources:
Abstract
188P - Survival and prognostic factors in cholangiocarcinoma: A single-center experience
Presenter: Sonngwit Payapwattanawong
Session: Poster display session
Resources:
Abstract
189P - Stereotactic body radiotherapy in primary hepatocellular carcinoma and oligometastatis to liver: A single Institution experience
Presenter: Sayan Paul
Session: Poster display session
Resources:
Abstract
190P - Details of response with first-line gemcitabine and nab-paclitaxel therapy in patients with advanced pancreatic cancer
Presenter: Yusuke Nagata
Session: Poster display session
Resources:
Abstract
191P - Assessment of efficacy and safety of sorafenib versus no treatment in Egyptian hepatocellular carcinoma patients
Presenter: Noha El Baghdady
Session: Poster display session
Resources:
Abstract
192P - Clinical importance of the determination of interleukin-6 in bile and blood in tumours of biliopancreatoduodenal zone
Presenter: Marufjon Salokhiddinov
Session: Poster display session
Resources:
Abstract
193P - Metastatic carcinoma gall bladder: A clinicoepidemiological profile of Indian patients
Presenter: Anvesh Rathore
Session: Poster display session
Resources:
Abstract