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Metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy

BACKGROUND: The treatment of carcinoma of unknown primary based on histopathology and immunohistochemistry is generally chemotherapy. The use of molecular markers, genetic profiling platforms, and personalized medicine is under active investigation. CASE REPORT: We report the case of a 56-year-old p...

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Autores principales: Usón Junior, Pedro Luiz Serrano, Wagner, Jairo, Corpa, Marcus Vinicius de Nigro, Coelho, Iracema Moraes, Nagourney, Robert A, Yamaguchi, Nise Hitomi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429643/
https://www.ncbi.nlm.nih.gov/pubmed/30915220
http://dx.doi.org/10.1177/2050313X19838739
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author Usón Junior, Pedro Luiz Serrano
Wagner, Jairo
Corpa, Marcus Vinicius de Nigro
Coelho, Iracema Moraes
Nagourney, Robert A
Yamaguchi, Nise Hitomi
author_facet Usón Junior, Pedro Luiz Serrano
Wagner, Jairo
Corpa, Marcus Vinicius de Nigro
Coelho, Iracema Moraes
Nagourney, Robert A
Yamaguchi, Nise Hitomi
author_sort Usón Junior, Pedro Luiz Serrano
collection PubMed
description BACKGROUND: The treatment of carcinoma of unknown primary based on histopathology and immunohistochemistry is generally chemotherapy. The use of molecular markers, genetic profiling platforms, and personalized medicine is under active investigation. CASE REPORT: We report the case of a 56-year-old patient who presented to medical attention with palpable axillary adenopathy. Biopsy confirmed poorly differentiated adenocarcinoma. Formal staging revealed extensive metastatic disease to bone and liver. Initial chemotherapy proved ineffective. We describe the diagnostic evaluation, treatment, and achievement of durable remission using a novel sorafenib-based drug combination that was chosen through the application of a functional analytic laboratory platform. CONCLUSION: The clinical management of patients with carcinoma of unknown primary continues to present a considerable challenge for practicing oncologists. Laboratory platforms capable of examining cellular response to injury, growth factor withdrawal, and cytotoxic insult at the level of cellular function may provide insights for drug selection in this patient population.
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spelling pubmed-64296432019-03-26 Metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy Usón Junior, Pedro Luiz Serrano Wagner, Jairo Corpa, Marcus Vinicius de Nigro Coelho, Iracema Moraes Nagourney, Robert A Yamaguchi, Nise Hitomi SAGE Open Med Case Rep Case Report BACKGROUND: The treatment of carcinoma of unknown primary based on histopathology and immunohistochemistry is generally chemotherapy. The use of molecular markers, genetic profiling platforms, and personalized medicine is under active investigation. CASE REPORT: We report the case of a 56-year-old patient who presented to medical attention with palpable axillary adenopathy. Biopsy confirmed poorly differentiated adenocarcinoma. Formal staging revealed extensive metastatic disease to bone and liver. Initial chemotherapy proved ineffective. We describe the diagnostic evaluation, treatment, and achievement of durable remission using a novel sorafenib-based drug combination that was chosen through the application of a functional analytic laboratory platform. CONCLUSION: The clinical management of patients with carcinoma of unknown primary continues to present a considerable challenge for practicing oncologists. Laboratory platforms capable of examining cellular response to injury, growth factor withdrawal, and cytotoxic insult at the level of cellular function may provide insights for drug selection in this patient population. SAGE Publications 2019-03-21 /pmc/articles/PMC6429643/ /pubmed/30915220 http://dx.doi.org/10.1177/2050313X19838739 Text en © The Author(s) 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Usón Junior, Pedro Luiz Serrano
Wagner, Jairo
Corpa, Marcus Vinicius de Nigro
Coelho, Iracema Moraes
Nagourney, Robert A
Yamaguchi, Nise Hitomi
Metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy
title Metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy
title_full Metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy
title_fullStr Metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy
title_full_unstemmed Metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy
title_short Metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy
title_sort metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429643/
https://www.ncbi.nlm.nih.gov/pubmed/30915220
http://dx.doi.org/10.1177/2050313X19838739
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