Verma Saurav, Vadlamani Surya Prakash, Shamim Shamim Ahmed, Barwad Adarsh, Rastogi Sameer, Raj S T Arun
Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Clin Sarcoma Res. 2020 Dec 12;10(1):28. doi: 10.1186/s13569-020-00149-1.
Chordoma is a rare, slow growing and locally aggressive mesenchymal neoplasm with uncommon distant metastases. It is a chemo-resistant disease with surgery and radiotherapy being the mainstay in treatment of localized disease. In advanced disease imatinib has a role. We report a case of metastatic sacral chordoma with symptomatic and radiological response to erlotinib post-progression on imatinib.
A 48-year-old male with a sacral chordoma underwent partial sacrectomy followed by post-operative radiotherapy. Upon recurrence he received palliative radiotherapy to hemipelvis and was offered therapy with imatinib. However, the disease was refractory to imatinib and he was started on treatment with erlotinib-showing a partial response on imaging at two months. He is currently doing well at 13 months since start of erlotinib.
As seen in previously reported cases, erlotinib is a therapeutic option in advanced chordoma, even in imatinib refractory cases and thus warrants exploration of its therapeutic role in prospective clinical trials.
脊索瘤是一种罕见的、生长缓慢且具有局部侵袭性的间叶性肿瘤，远处转移不常见。它是一种化疗耐药性疾病，手术和放疗是局限性疾病治疗的主要手段。在晚期疾病中，伊马替尼有一定作用。我们报告一例转移性骶骨脊索瘤病例，该病例在伊马替尼治疗进展后对厄洛替尼出现症状和影像学反应。
一名患有骶骨脊索瘤的48岁男性接受了部分骶骨切除术，随后进行术后放疗。复发后，他接受了半骨盆姑息性放疗，并接受伊马替尼治疗。然而，该疾病对伊马替尼耐药，随后他开始接受厄洛替尼治疗，两个月时影像学显示部分缓解。自开始使用厄洛替尼以来，他目前在13个月时情况良好。
如先前报道的病例所示，厄洛替尼是晚期脊索瘤的一种治疗选择，即使在伊马替尼耐药的病例中也是如此，因此有必要在前瞻性临床试验中探索其治疗作用。
