logging in or signing up Male adeno never smoker uberkinger Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 30 Category: Science & Tech.. License: All Rights Reserved Like it (0) Dislike it (0) Added: November 22, 2009 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript Case Mr M : Case Mr M FICTITIOUS CASE FOR DEMONSTRATION PURPOSES ONLY Mr M : Mr M 52 year old male, never smoker WHO PS 1 Presented May 2002 8 month history cough 4 month history left shoulder pain No response to antibiotics CXR- “left basal consolidation” Mr M Investigations : Mr M Investigations Bronchoscopy normal CT Thorax/Abdo 3.7 cm lesion in left upper lobe Multiple enlarged mediastinal nodes, right paratracheal, pretracheal and subcarinal Multiple contralateral parenchymal nodules Left pleural effusion Pleura within effusion appears thickened Mr M CT Scan : Mr M CT Scan Mr M Operative findings : Mr M Operative findings Left VATS/Pleurodesis/ transthoracic US 2300 mls pleural effusion Multiple nodular seedings parietal/visceral pleura/diaphragm/pericardium Biopsy of pleural nodules Talc pleurodesis Mr M Pathology : Mr M Pathology Moderate to poorly differentiated adenocarcinoma in keeping with a lung primary CK7+ve, CK20 +ve, TTF1+ve, Ca125 +ve, focally ER +ve but GCDFP –ve Questions…… : Questions…… Treatment options? : Treatment options? Platinum doublet, (which?) Platinum doublet + Bevacizumab Platinum doublet + Cetuximab Erlotinib option (evidence?) Other ? Mr M June 2007 after 4 cycles gemcitabine/platinum…. : Mr M June 2007 after 4 cycles gemcitabine/platinum…. Mr M : Mr M Received 4 cycles of platinum doublet chemotherapy Partial response on RECIST criteria Recurrence October 2002 (7 month gap) Treatment options ? : Treatment options ? Pemetrexed Docetaxel Erlotinib Re-treat with platinum doublet Avastin Cetuximab Other ? Mr M Treatment : Mr M Treatment 4 cycles 2nd line chemotherapy completed March 2003 CT shows stable disease Clinically well until July 2003 Pain in left ribs and back August 2003 : August 2003 Treatment options? : Treatment options? Radiotherapy Pemetrexed Docetaxel Erlotinib Alternate platinum doublet Bevacizumab Cetuximab Other ? Other factors to influence the choice of treatment……… : Other factors to influence the choice of treatment……… Performance Status….. Histology…. Smoking status…. Other….? You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Male adeno never smoker uberkinger Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 30 Category: Science & Tech.. License: All Rights Reserved Like it (0) Dislike it (0) Added: November 22, 2009 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript Case Mr M : Case Mr M FICTITIOUS CASE FOR DEMONSTRATION PURPOSES ONLY Mr M : Mr M 52 year old male, never smoker WHO PS 1 Presented May 2002 8 month history cough 4 month history left shoulder pain No response to antibiotics CXR- “left basal consolidation” Mr M Investigations : Mr M Investigations Bronchoscopy normal CT Thorax/Abdo 3.7 cm lesion in left upper lobe Multiple enlarged mediastinal nodes, right paratracheal, pretracheal and subcarinal Multiple contralateral parenchymal nodules Left pleural effusion Pleura within effusion appears thickened Mr M CT Scan : Mr M CT Scan Mr M Operative findings : Mr M Operative findings Left VATS/Pleurodesis/ transthoracic US 2300 mls pleural effusion Multiple nodular seedings parietal/visceral pleura/diaphragm/pericardium Biopsy of pleural nodules Talc pleurodesis Mr M Pathology : Mr M Pathology Moderate to poorly differentiated adenocarcinoma in keeping with a lung primary CK7+ve, CK20 +ve, TTF1+ve, Ca125 +ve, focally ER +ve but GCDFP –ve Questions…… : Questions…… Treatment options? : Treatment options? Platinum doublet, (which?) Platinum doublet + Bevacizumab Platinum doublet + Cetuximab Erlotinib option (evidence?) Other ? Mr M June 2007 after 4 cycles gemcitabine/platinum…. : Mr M June 2007 after 4 cycles gemcitabine/platinum…. Mr M : Mr M Received 4 cycles of platinum doublet chemotherapy Partial response on RECIST criteria Recurrence October 2002 (7 month gap) Treatment options ? : Treatment options ? Pemetrexed Docetaxel Erlotinib Re-treat with platinum doublet Avastin Cetuximab Other ? Mr M Treatment : Mr M Treatment 4 cycles 2nd line chemotherapy completed March 2003 CT shows stable disease Clinically well until July 2003 Pain in left ribs and back August 2003 : August 2003 Treatment options? : Treatment options? Radiotherapy Pemetrexed Docetaxel Erlotinib Alternate platinum doublet Bevacizumab Cetuximab Other ? Other factors to influence the choice of treatment……… : Other factors to influence the choice of treatment……… Performance Status….. Histology…. Smoking status…. Other….?