Du Zedong, Yu Yanxin, Wu Dajun, Zhang Guangyu, Wang Yang, He Liang, Meng RongQin
Department of Oncology of 363 Hospital, Cheng Du.
Department of Radiation Oncology of 363 Hospital, Cheng Du, China.
Medicine (Baltimore). 2018 Nov;97(45):e13105. doi: 10.1097/MD.0000000000013105.
Malignant Pleural Mesothelioma (MPM) is rare cancer and has a poor prognosis with resistance to chemotherapy or radiotherapy. Until now there is no standard third-line treatment for patients who have failed second-line therapy.
A 58-year-old non-smoking female peasant of ethnic Han was admitted to the oncology department of the 363 Hospital with a primary complaint of chest tightness and breathlessness from 3 months ago.
Positron emission tomography-computed tomography (PET/CT) examination showed "dirty" pleural and parietal pleural involvement as well as mediastinal and pulmonary hilar lymph node enlargement. Finally, cancer cells were seen after repeated pleural effusion cell examination. Immunohistochemistry confirmed epithelioid of pleural mesothelioma.
Apatinib as a third-line treatment after failure from pemetrexed/cisplatin (PC) as the first-line chemotherapy and gemcitabine/cisplatin (GP) as the second-line chemotherapy. At first, 250 mg/day was given and 1 week later, the dose was increased to 500 mg/day.
A 5-month progression-free survival was achieved and toxicity included severe hand-foot syndrome, mild proteinuria, and hypertension.
Apatinib may be a potential therapeutic drug for MPM, particularly as a third-line treatment in cases resistant to chemotherapeutic options.
恶性胸膜间皮瘤（MPM）是一种罕见的癌症，预后较差，对化疗或放疗具有耐药性。到目前为止，对于二线治疗失败的患者尚无标准的三线治疗方案。
一名58岁的汉族非吸烟女性农民因3个月前出现胸闷和呼吸困难的主要症状入住363医院肿瘤科。
正电子发射断层扫描-计算机断层扫描（PET/CT）检查显示“脏层”胸膜和壁层胸膜受累，以及纵隔和肺门淋巴结肿大。反复进行胸腔积液细胞检查后最终发现癌细胞。免疫组织化学证实为胸膜间皮瘤上皮样型。
在培美曲塞/顺铂（PC）作为一线化疗和吉西他滨/顺铂（GP）作为二线化疗失败后，使用阿帕替尼作为三线治疗。起初，给予250毫克/天，1周后剂量增加至500毫克/天。
实现了5个月的无进展生存期，毒性包括严重的手足综合征、轻度蛋白尿和高血压。
阿帕替尼可能是MPM的一种潜在治疗药物，特别是作为对化疗方案耐药病例的三线治疗。
