Improving Overall Survival In Extensive Stage Small Cell Lung Cancer

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Improving Overall Survival In Extensive Stage Small Cell Lung Cancer

Case: A 73-Year-Old Female With Stage IV SCLC

Initial presentation

  • A 73-year—old woman presented with shortness of breath, productive cough, chest pain, fatigue, anorexia and an 18-lb weight loss.
  • PMH: HTN
  • SH: Elementary school teacher; 50 pack year smoking history; quit 6 years ago; married with 2 children and her first grandchild on the way.
  • PE: Dullness to percussion, decreased breath sounds, BMI 17

Clinical workup

  • Imaging:
    • Chest x-ray showed a hilar mass and a 5.4cm right lower lobe mass
    • Chest/abdomen/pelvic CT scan revealed mediastinal adenopathy, right lower lung lobe mass, suspicious liver lesions
    • PET scan showed activity in the left upper lobe mass and supraclavicular nodal areas and liver lesions
    • No metastases to brain on MRI
  • IR biopsy of liver revealed small cell lung cancer
  • Staging: T3N3M1 - IVb
  • ECOG PS 1

Treatment

  • Concurrent durvalumab with carboplatin/etoposide; has completed 4 cycles
  • Developed constipation and nausea after second cycle (constipation successfully treated with increased oral hydration and docusate; nausea treated with ondansetron)
  • Repeated chest/abdomen/pelvis CT with contrast after every 2 cycles demonstrated significant response. After 4 cycles patient started maintenance durvalumab for 6 months
  • Continued durvalumab every 4 weeks, with CT scans at 3 and 6 months
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Presented by the Onc Brothers
Presented by the Onc Brothers
Presented by the Onc Brothers
Presented by the Onc Brothers
Jamie L. Koprivnikar, MD, an expert on MDS
Jamie L. Koprivnikar, MD, an expert on MDS
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