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Lung carcinoma – imaging on the molecular level
05/2020 Prof. MUDr. Jiří Ferda, Ph.D., MUDr. Eva Ferdová, doc. MUDr. Jan Baxa, Ph.D., prof. MUDr. Miloš Pešek, CSc., MUDr. Petr Mukenšnabl, Ph.D., doc. MUDr. Hynek Mírka, Ph.D.
Molecular imaging in lung carcinoma are being the basic diagnostic approaches in the confirmation of the tumorous origin of the disease, but also in staging and restaging of the disease. Positron emission tomography / computed tomography (PET/CT) with the application of 18F-fluorodeoxyglucose is the most frequent molecular imaging in lung tumors, it is used as the fundament of the clinical stage of the disease before start of the treatment. Positron emission tomography / magnetic resonance imaging (PET/MRI) enables to complete the imaging with the full valid brain magnetic resonance imaging during the own procedure, the main disadvantage of PET/MRI is the prolonged scanning, making time unacceptable for those patients, who are heavier clinical state. The alternative way of the pharmacokinetics evaluation could be the analysis of iodine content within tissues using dynamic perfusion computed tomography (CT) or dual-energy CT. The use of other radiopharmaceuticals like 18F-ftuorthymidine in tissue proliferation or 68Ga-DOTA derivate in the assessment of somatostatin receptor density could provide the supplementary information about tumor biology.
ENTIRE ARTICLE
Molecular imaging in lung carcinoma are being the basic diagnostic approaches in the confirmation of the tumorous origin of the disease, but also in staging and restaging of the disease. Positron emission tomography / computed tomography (PET/CT) with the application of 18F-fluorodeoxyglucose is the most frequent molecular imaging in lung tumors, it is used as the fundament of the clinical stage of the disease before start of the treatment. Positron emission tomography / magnetic resonance imaging (PET/MRI) enables to complete the imaging with the full valid brain magnetic resonance imaging during the own procedure, the main disadvantage of PET/MRI is the prolonged scanning, making time unacceptable for those patients, who are heavier clinical state. The alternative way of the pharmacokinetics evaluation could be the analysis of iodine content within tissues using dynamic perfusion computed tomography (CT) or dual-energy CT. The use of other radiopharmaceuticals like 18F-ftuorthymidine in tissue proliferation or 68Ga-DOTA derivate in the assessment of somatostatin receptor density could provide the supplementary information about tumor biology.
Management of diarrhea as an undesirable effect of treatment with afatinib – case report
06/2017 MUDr. Gabriela Krákorová, Ph.D., MUDr. Hynek Mírka, Ph.D., prof. MUDr. Miloš Pešek, CSc.
Afatinib is an oral preparation, a tyrosine kinase inhibitor of the second-generation EGFR. It is used in the treatment of unresectable locally advanced or metastatic non-small cell lung carcinoma in patients with positive mutations in the gene encoding the epidermal growth factor receptor (EGFR). Afatinib as the first tyrosine kinase inhibitor EGFR demonstrated overall survival compared to chemotherapy in patients with positive EGFR mutation on exon 19 (prolongation of median survival by 12.2 months using afatinib). The most common side effects are rash, diarrhea, stomatitis and paronychia. To cope with side effects, patients need to be cooperative and well informed. At the clinic of pneumology and phthisiology, we have witnessed a brief written lesson that is part of a medical report. In the case of diarrhea, adequate hydration, dietary precautions, and the use of loperamide, which should be provided to patients immediately upon initiation of treatment with afatinib. The case study demonstrates good controlled side effects in collaborating patients with high adherence to treatment. In line with the literature, a good therapeutic effect remains unaffected even when reducing the daily dose of afatinib by half.
ENTIRE ARTICLE
Afatinib is an oral preparation, a tyrosine kinase inhibitor of the second-generation EGFR. It is used in the treatment of unresectable locally advanced or metastatic non-small cell lung carcinoma in patients with positive mutations in the gene encoding the epidermal growth factor receptor (EGFR). Afatinib as the first tyrosine kinase inhibitor EGFR demonstrated overall survival compared to chemotherapy in patients with positive EGFR mutation on exon 19 (prolongation of median survival by 12.2 months using afatinib). The most common side effects are rash, diarrhea, stomatitis and paronychia. To cope with side effects, patients need to be cooperative and well informed. At the clinic of pneumology and phthisiology, we have witnessed a brief written lesson that is part of a medical report. In the case of diarrhea, adequate hydration, dietary precautions, and the use of loperamide, which should be provided to patients immediately upon initiation of treatment with afatinib. The case study demonstrates good controlled side effects in collaborating patients with high adherence to treatment. In line with the literature, a good therapeutic effect remains unaffected even when reducing the daily dose of afatinib by half.