Ahmad Yaser, Tanvetyanon Tawee
Medicine, Morsani College of Medicine, Tampa, USA.
Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, USA.
Cureus. 2023 Jan 21;15(1):e34033. doi: 10.7759/cureus.34033. eCollection 2023 Jan.
Advanced cancers may be accompanied by paraneoplastic disseminated intravascular coagulation (DIC), resulting in thromboembolism or thrombocytopenia. Thrombocytopenia can limit the feasibility of myelosuppressive chemotherapy. Therefore, an alternative treatment option is needed. This report described a patient with metastatic pulmonary adenocarcinoma with exon 20 insertion and paraneoplastic DIC. Frontline chemotherapy failed to control the disease and worsened thrombocytopenia. However, treatment with amivantamab resulted in a rapid resolution of DIC and produced a partial tumor response. Based on our experience, for patients with exon 20 insertions with paraneoplastic DIC, amivantamab could be considered a preferred frontline treatment.
晚期癌症可能伴有副肿瘤性弥散性血管内凝血(DIC),导致血栓栓塞或血小板减少。血小板减少会限制骨髓抑制性化疗的可行性。因此,需要一种替代治疗方案。本报告描述了一名患有20号外显子插入型转移性肺腺癌并伴有副肿瘤性DIC的患者。一线化疗未能控制疾病且使血小板减少恶化。然而,使用阿美替尼治疗导致DIC迅速缓解并产生部分肿瘤反应。根据我们的经验,对于伴有副肿瘤性DIC的20号外显子插入型患者,阿美替尼可被视为首选的一线治疗药物。