Tumor board session I Clinical cases

Slides:

Advertisements

Similar presentations

BDS, LDSRCS, MSc, FFDRCSI Specialist Oral Surgeon

Advertisements

Radiologic Imaging Defines the local extent of a tumor Can be used to stage malignant disease Aids in the diagnosis Monitoring tumor changes after treatment.

Brain Neoplasm. Benign –May have aggressive tendencies –May transition to more aggressive lesion –Tends to be slower growing Primary malignant –Age distribution.

Extending life for women with HER2-positive MBC

Zeroing in on Non-Small Cell Lung Cancer: Integrating Targeted Therapies into Practice.

« A Clear cell sarcoma » FN. 25 year-old male January cm mass on the medial side of the right heel Early August cm clinical right.

Staging. Treatment by Stage For early stage lung cancers, surgery or radiation alone For larger tumors (>4 cm) and N+, chemotherapy should be added.

Do you know what ’ s in people ’ s head?. Brain tumors 72 male 72 male HPI: presents to E.R. with history of confusion, change of personality, left sided.

Matthew Kilmurry, M.D. St. Mary’s General Hospital Grand River Hospital.

Cases on 1st line use of Ipilimumab in BRAF+ patients, sequencing of therapies Erika Richtig.

Brain Tumors Maria Rountree. Most common types of brain tumors The most common childhood tumors are: The most common childhood tumors are: 1. Astrocytoma.

Lecturer of Medical-Surgical

CNS Tumor. Intracranial tumors can be classified in different ways: 1. primary versus secondary, 2. pediatric versus adult, 3. cell of origin, 4. location.

Selezione dei pazienti affetti da melanoma Vanna Chiarion Sileni Melanoma and Skin Cancer Unit IOV-IRCCS, Padova.

Spinal Cord Tumors By: Aunshka Collins.

AJCC Staging Moments AJCC TNM Staging 7th Edition Lung Case #3 Contributors: Valerie W. Rusch, MD Memorial Sloan-Kettering Cancer Center, New York, New.

SYSTEMIC THERAPY FOR UNRESECTABLE STAGE III OR METASTATIC CUTANEOUS MELANOMA Sarkheil Mehdi Hematologist- oncologist.

© Copyright 2003 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved. PET in Breast Cancer Early detection of disease Precise Staging.

Breast Cancer Clinical Cases Daniel A. Nikcevich, MD, PhD SMDC Cancer Center April 20, 2009.

Case Study 63: Cancer of the Female Breast

CNS Neoplasm Dr. Raid Jastania, FRCPC Assistant Professor, Faculty of Medicine, Umm Alqura University Vice Dean, Faculty of Dentistry.

Acinic Cell Carcinoma of the Parotid Gland Metastatic to the Epidermis of the Back Pilcher R. Davidson MJC. Department of Oral and Maxillofacial Surgery,

New Developments in Cancer Treatment Dulcinea Quintana, MD.

LUNG CANCER Dr.Mohammadzadeh. Lung cancer is the leading cancer killer in the United States. Every year, it accounts for 30% of all cancer deaths— more.

Copyright © 2011 Research To Practice. All rights reserved. Case presented by Dr Schwartz 44 yo woman with 4 mo hx of abdominal pain –Imaging = pancreatic.

4.1b. Pre-contrast Axial T1 Wtd MRI4.1c. Post-contrast Axial T1 Wtd MRI4.1a. Axial T2 Wtd MRI 4.1d. Post-contrast Sagittal T1 Wtd MRI Patient with Intra-cranial.

Targeting HER2 and Focusing on Patients With Gastric Cancer Jose Maria Vieitez, MD, PhD Assistant Professor of Oncology Department of Medical Oncology.

NYU Medical Grand Rounds Clinical Vignette Lisa Cioce MD, PGY-2 March 10, 2010 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.

Palliative Care Eyad Al-Saeed, MD,FRCPC Consultant Radiation Oncology Prince Sultan Hematology Oncology Center.

NEOPLASM OF THE CENTRAL NERVOUS SYSTEM. DR. AMITABHA BASU MD.

NYU Medical Grand Rounds Clinical Vignette Rachel Shur PGY-2 October 16, 2012 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.

Diagnostic Challenge Pathology for Neurosurgery & Neurology Residents Department of Pathology University of Oklahoma Health Sciences Center, Oklahoma City,

Brain:Spinal cord tumors 10:1

Liver Cancer  A leading cause of death in the world  Can be primary or a metastatic site  Seen more in other parts of the world  incidence African.

Anaplastic thyroid cancer based on ATA guideline for Management of Patients with ATC. Thyroid. 2012;22: R3 이정록.

Personalized medicine in lung cancer R4 김승민. Personalized Medicine in Lung Cancer patients with specific types and stages of cancer should be treated.

Lung cancer Gene Kukuy, MD Cardiothoracic Surgery.

Authors: Syed H. Jafri ¹, Angel I. Blanco¹, Bonnie A. Labdi², Shan Guo¹. UT Houston department of medicine, Division of Oncology Department of Pharmacy.

Brain Tumors David A. Sun, M.D., Ph.D. Neurosurgery.

CASE 1: Management of metastatic disease in a resource-limited setting

Principles and Practice of Radiation Therapy

Case Presentation Int 張修碩.

Neurological Neoplasm FOM, KFMC

Junliang Liu, M.D., M.Sc. Ph.D., FRCPC Assistant Professor

CheckMate 204: Nivolumab + Ipilimumab in Pts With Advanced Melanoma and Asymptomatic, Untreated Brain Metastases CCO Independent Conference Highlights*

“CASE SERIES OF EGFR MUTATIONS IN SQUAMOUS CELL CARCINOMA LUNG ”

Percutaneous Cryoablation of Metastatic Ovarian Cancer for Local Tumor Control: Improved Patient Survival and Estimated Cost-Effectiveness Brandt P. Currier.

Fig year-old female patient with two months of headaches and falls and a remote history of right lung lobectomy for reported benign tumor with MR.

Angela Lignelli, MD, Alexander G. Khandji, MD Neurosurgery Clinics

PET/CT Fusion Scan in Lung Cancer: Current Recommendations and Innovations Cristina Gámez, MD, PhD, Rafael Rosell, MD, PhD, Alejandro Fernández, MD, PhD,

Metastatic Breast cancer

Neuro-oncology Board Review

Case Study 41 Henry Armah, M.D., M.Phil..

Leptomeningeal Disease

Radiologic Characteristics of Surgically Resected Non-Small Cell Lung Cancer With ALK Rearrangement or EGFR Mutations Tae Jung Kim, MD, PhD, Choon-Taek.

Jasmin JO and David Schiff

Adam L. Cohen, MD, MS Assistant Professor Division of Oncology

Case 1 South Bay Pathology Society May 2009

Rapid Response of Brain Metastasis to Crizotinib in a Patient with ALK Rearrangement– Positive Non–Small-Cell Lung Cancer Hiroyasu Kaneda, MD, PhD, Isamu.

Surgical Management of Brain Metastases

MX39795 Study Design Category 1 R 3:1 Category 2 Inclusion criteria

Choroidal Metastases Responsive to Crizotinib Therapy in a Lung Adenocarcinoma Patient with ALK 2p23 Fusion Identified by ALK Immunohistochemistry Yan.

A Case of ALK-Rearranged Adenocarcinoma with Small Cell Carcinoma-Like Transformation and Resistance to Crizotinib Yoon Jin Cha, MD, PhD, Byoung Chul.

Small Cell Lung Cancer Transformation as a Mechanism of Resistance to PD-1 Therapy in KRAS-Mutant Lung Adenocarcinoma: A Report of Two Cases Wade T.

CNS tumors Dr. Waleed Dabbas.

Concomitant Epidermal Growth Factor Receptor Mutation and EML4-ALK Fusion in a Patient with Multifocal Lung Adenocarcinomas Jun Fan, MD Journal of Thoracic.

CASE REVIEW 강동경희대병원 이한나.

General strategies of Cancer Treatment and evaluation of Response

Adding Bevacizumab to Chemotherapy Effectively Control Radioresistant Brain Metastases in ALK-Positive Lung Adenocarcinoma Yu-Li Su, MD Journal of Thoracic.

Presentation transcript:

Tumor board session I Clinical cases Carlos Vargas, MD. Camilo Fadul MD, FACN. Andrés Felipe Cardona, MD MSc PhD. Hernán Carranza, MD MSc. Javier Segovia, MD. Álvaro Muñoz, MD. Juan Fernando Ramón, MD MSc

Brain metastasesof BRAF+ melanoma Case 1 Brain metastasesof BRAF+ melanoma 63-year-old female Mother and daughter with melanoma (Familial Atypical Multiple Melanoma Syndrome) Abnormal melanotic lesion in right ear (malignant melanoma, Clark IV, Breslow 3.2 mm) First genomic evaluation: p16INK4+/BRAFV600K+ Symptoms: numbness and weakness in her left leg Spinal MRI revealed metastatic disease involving the spinal cord at C5 and T3, and 8 mm focal-enhancing T1 metástasis in T1. A brain MRI scan revealed four metastases, including a dominant 3.5×2.2×2.7 cm lesion in the right posterior parietal cortex

Brain metastasesof BRAF+ melanoma Case 1 Brain metastasesof BRAF+ melanoma Treatment: Parietal cortex lesion was surgically removed (01.2012) SRS (3 aditional lesions; 02.2012) TMZ 200 mg/m2 5/28 x 7 cycles (SD + TTP 8.2 months → 09.2012) Lung and bone progression Ipilimumab/Zoledronic acid x 4 cycles (PR + TTP 13 months → 12.2013) Edema surrounding previously identified brain and cord metastases Bevacizumab 7.5 mg/kg x 3 cycles + Celecoxib 200 mg qd (complete regression of edema) Brain progression (4 additional metastases) SRS + Ipilimumab reinduction → Ipi maintenance (PR + TTP 9 months → 10.2014)

Pre-Ipi therapy Post-Ipi therapy

Brain metastasesof BRAF+ melanoma Case 1 Brain metastasesof BRAF+ melanoma Treatment: Brain and lung progression Vemurafenib (SD + TTP 5.6 months → 05.2015) Brain, bone and live progression h. Carboplatin/Weekly paclitaxel (PR + TTP 6.0 months → 11.2015)

Brain metastasesof EGFR+ LAC Case 2 Brain metastasesof EGFR+ LAC 2012 Case presentation 61 year old man Former smoker (2 cigarettes/day for 5 years) Family history: none Presents with headache related to brain metastases/leptomeningeal disease PET/CT shows spiculated LUL mass Biopsy: lung adenocarcinoma (TTF1+, Napsin A+, Ck7+) First genomic evaluation: EGFRdel19/T790M basal(-), ALK(-), TS (T1)/ERCC1(T1)

Response to erlotinib in first line Pre-erlotinib 8 weeks post-erlotinib

Anaplastic meningioma Case 3 Anaplastic meningioma Case presentation 54 year-old female Previous history of early breast cancer (1996) Clinical history 4 years (unstable gait, tremor and seizures) Right parasagittal parietal meningioma adjacent to the right precentral gyrus Treatment: Primary resection (11.05.1998) → Atypical meningioma (no residual disease) Secondary resection (20.02.2007) → Atypical meningioma (no residual disease) IMRT (04.2007; CR → TTP 19 months) Tertiary resection (06.2009; Two nodules of residual disease with estimated volume of 36 mm3) SRS (08.2009; PR → TTP 14 months)

Genomic evaluation (2013): SR2(-)/TSLC1(+)/PDGFR(-)/NF2c. 699G:T (p Genomic evaluation (2013): SR2(-)/TSLC1(+)/PDGFR(-)/NF2c.699G:T (p.Leu233Leu)

Anaplastic meningioma Case 3 Anaplastic meningioma Treatment: f. Everolimus + Octeotride (12.2010; PR → TTP 26 months) g. Bevacizumab monotherapy 15 mg/kg q15 days (03.2013; SD → TTP 9 months) h. Sunitinib 37 mg qd (02.2014; PR → TTP 28 months – current treatment) Overall survival with targeted therapy: 63 months CD34 VEGF

Supratentorial primitive neuroectodermal tumor Case 4 Supratentorial primitive neuroectodermal tumor Case presentation 52 year-old female No previous history Clinical history 1 month (dense quadriparesis and sensory alteration with T1 level) Large extramedullary intradural expansive lesion extending from the occipital foramen to C3-4 involving the posterior aspect of the left canal and right frontal lobe nodule (22 mm) Treatment: Partial resection (09.2013) → PNET (positive immunohistochemistry for CD99 and synaptophysin, and negative for NG84, EMA, PFAG and TTF1) Carboplatin/Etoposide/Cy x 3 cycles (10.02.2013; CR) Craniospinal radiotherapy (06.2013; CR)