20 marzo 2024
Miocarditis Fulminante Durante Quimioterapia Adyuvante Postoperatoria Para Cáncer de Pulmón con ATEZOLIZUMAB : Reporte de un Caso .
Fulminant Myocarditis During Postoperative Adjuvant Chemotherapy For LUNG CÁNCER With ATEZOLIZUMAB : A Case Report .
Background
Postoperative adjuvant systemic therapy with ATEZOLIZUMAB for lung cancer has been reported to be effective. Although myocarditis is a rare immune adverse event associated with atezolizumab, it can have a serious course and should be treated with caution. We herein report a case of fulminant Myocarditis during adjuvant systemic therapy with ATEZOLIZUMAB .
Case Presentation
The patient was a 49-year-old Asian woman. She was diagnosed with pT2aN1M0 stage IIB (Programmed Death Ligand 1(PD-L1), 50%) after surgery for right upper lobe lung adenocarcinoma. ATEZOLIZUMAB was administered following platinum-based adjuvant chemotherapy. On day 14, the patient was hospitalized because of deterioration in her general condition caused by fever. On day 16, she developed dyspnea, which worsened, and on day 17, she experienced shock. Blood tests, echocardiography, and cardiac catheterization were performed, and the patient was diagnosed with cardiogenic shock due to myocarditis. Initial measures did not improve the patient’s shock state. The patient was transferred to hospital for the use of an assistive circulatory system. Pulse steroid therapy was administered, and myocarditis showed a tendency toward improvement. A retrospective review of the patient’s history revealed a decreased lymphocyte count and an increase in the neutrophil/lymphocyte ratio, which may be useful for detecting severe immune-related adverse events. The troponin levels were elevated, but creatine phosphokinase level remained within the normal range .
Conclusion
Myocarditis can be fatal due to the rapid progression of symptoms. Close follow-up, a prompt diagnosis, and therapeutic intervention are important. Decreased lymphocyte counts, increased neutrophil/lymphocyte ratios, and the measurement of multiple myocardial biomarkers are considered useful for the early diagnosis of Myocarditis .
SMALL_CELL_LUNG_CANCER SEGUNDA LÍNEA . ANLOTINIB CAPSULA ESTA OBTENIENDO RESULTADOS QUÉ HABLAN DE : *.- RESPUESTAS COMPLETAS ... *.- DE TASAS DE CONTROL DE LA ENFERMEDAD ( DCR ) DEL 80,6% ... **.- Y DE UNA SUPERVIVENCIA GENERAL NUNCA ANTES VISTA EN COMPARACIÓN CON LA QUIMIOTERAPIA SOLA ( 19,3 MESES FRENTE A 11,9 MESES ; P = 0,0002 ) . ¡ EN DEFINITIVA SE TRATA DE UNA ACTIVIDAD CLÍNICA Y UNA SEGURIDAD DE NOTA CON ANLOTINIB ORAL COMBINADO CON BLOQUEOS DE PD-1 ! .
“ Durante los Últimos 24 Años, el Pronóstico del SMALL CELL LUNG CÁNCER NO Ha Cambiado Mucho . La Mediana de Supervivencia General es de Menos de 1 Año ”.
A Fecha de Hoy Tan Solo el TOPOTECAN CUENTA con FULL APPROVAL y Por Tanto es el Tratamiento STANDAR a Batir ... Y Ya Son Varios los Candidatos Bien Posicionados en la Carrera Por Conseguirlo .
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