FDA issues a not approvable letter for Novocure’s Optune Mya in NSCLC brain metastases, citing uncertain clinical benefit. No safety concerns were raised.
|Videos|December 18, 2020
A 61-Year-Old Man With Small Cell Lung Cancer
Author(s)Ticiana Leal, MD
Ticiana Leal, MD, presents a case of a 61-year-old man with small cell lung cancer.
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Case: A 61-Year-Old Man With Small-Cell Lung Cancer
Initial Presentation
- A 61-year-old man presented with a cough, fatigue, progressive shortness of breath
- PMH: unremarkable
- SH: 25-pack year smoking history; social alcohol use
- PE: Right lower lobe wheezing on auscultation, axillary lymph node enlargement
Clinical Workup
- Labs: WNL
- Axillary lymph node biopsy revealed small cell carcinoma
- Chest/abdomen/pelvic CT showed a 7.1 cm mediastinal conglomerate mass, with invasion into the right main and lobar pulmonary arteries; 2 small left pulmonary nodules; hypermetabolic axillary lymph node
- PET scan showed large focal hypermetabolic activity in the mediastinum and small hypermetabolic activity in the surrounding area
- Contrast‐enhanced MRI of the head showed no brain metastases
- Stage IV small-cell lung cancer; ECOG PS 0
Treatment
- Initiated carboplatin + etoposide + atezolizumab for 4 cycles; followed with atezolizumab as maintenance therapy
Follow-up
- 7 months after starting treatment he complained of shortness of breath, right upper quadrant pain and back pain
- CT showed hematogenous metastases in the liver and right adrenal gland
- Initiated lurbinectedin 3.2 mg/m2 IV q21 Days
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