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Stabilization of metastatic myxopapillary ependymoma with sorafenib.

Fegerl G, Marosi C - Rare Tumors (2012)

Bottom Line: As neither resection, debulking, nor radiation therapy were considered to be indicated, systemic therapy with temozolomide was started.Imatinib delayed the progression, but had to be stopped after six months because of critical increased pleural effusion.Using the multikinase inhibitor sorafenib, the disease was stabilized and an acceptable quality of life could be obtained for one year.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna;

ABSTRACT
We report on a 59-year old woman with three huge intrathoracal masses that were accidentally diagnosed when she consulted a physician for upper abdominal discomfort. A biopsy revealed that they were metastases of a coccygeal myxopapillary ependymoma, resected 20 years before. As neither resection, debulking, nor radiation therapy were considered to be indicated, systemic therapy with temozolomide was started. At the first evaluation after four months, the metastases had progressed. Imatinib delayed the progression, but had to be stopped after six months because of critical increased pleural effusion. Using the multikinase inhibitor sorafenib, the disease was stabilized and an acceptable quality of life could be obtained for one year.

No MeSH data available.


Related in: MedlinePlus

Electromyogram/nerve conduction study: decrease of amplitude and diminution of motoric nerve conduction velocity of the right (A) and left (B) N. peronaeus in March 2011.
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Figure 2: Electromyogram/nerve conduction study: decrease of amplitude and diminution of motoric nerve conduction velocity of the right (A) and left (B) N. peronaeus in March 2011.

Mentions: Sorafenib, a multikinase inhibitor affecting tumor growth and angiogenesis by inhibiting intracellular RAF kinases and cell surface kinase receptors (VEFGR 2–3, PDGFRb, cKIT, FLT-3) was the next strategy. It was attractive due to its target profile, manageable toxicity profile and its oral availability. With this drug, the disease was stabilized for a year. But after this prolonged use of sorafenib, the patient increasingly experienced gait disturbance and muscular weakness mainly of the proximal musculature. The symptoms worsened and, therefore, by March 2011, the patient was nearly immobile and had lost weight. A neurophysiological examination revealed a mixed axonal demyelinating polyneuropathy with toxic causality (Figure 2). We found no report for sorafenib inducing this form of neuropathy; only sensory forms are mentioned in the literature.21 After stopping sorafenib, the neuropathy slowly improved.


Stabilization of metastatic myxopapillary ependymoma with sorafenib.

Fegerl G, Marosi C - Rare Tumors (2012)

Electromyogram/nerve conduction study: decrease of amplitude and diminution of motoric nerve conduction velocity of the right (A) and left (B) N. peronaeus in March 2011.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3475949&req=5

Figure 2: Electromyogram/nerve conduction study: decrease of amplitude and diminution of motoric nerve conduction velocity of the right (A) and left (B) N. peronaeus in March 2011.
Mentions: Sorafenib, a multikinase inhibitor affecting tumor growth and angiogenesis by inhibiting intracellular RAF kinases and cell surface kinase receptors (VEFGR 2–3, PDGFRb, cKIT, FLT-3) was the next strategy. It was attractive due to its target profile, manageable toxicity profile and its oral availability. With this drug, the disease was stabilized for a year. But after this prolonged use of sorafenib, the patient increasingly experienced gait disturbance and muscular weakness mainly of the proximal musculature. The symptoms worsened and, therefore, by March 2011, the patient was nearly immobile and had lost weight. A neurophysiological examination revealed a mixed axonal demyelinating polyneuropathy with toxic causality (Figure 2). We found no report for sorafenib inducing this form of neuropathy; only sensory forms are mentioned in the literature.21 After stopping sorafenib, the neuropathy slowly improved.

Bottom Line: As neither resection, debulking, nor radiation therapy were considered to be indicated, systemic therapy with temozolomide was started.Imatinib delayed the progression, but had to be stopped after six months because of critical increased pleural effusion.Using the multikinase inhibitor sorafenib, the disease was stabilized and an acceptable quality of life could be obtained for one year.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna;

ABSTRACT
We report on a 59-year old woman with three huge intrathoracal masses that were accidentally diagnosed when she consulted a physician for upper abdominal discomfort. A biopsy revealed that they were metastases of a coccygeal myxopapillary ependymoma, resected 20 years before. As neither resection, debulking, nor radiation therapy were considered to be indicated, systemic therapy with temozolomide was started. At the first evaluation after four months, the metastases had progressed. Imatinib delayed the progression, but had to be stopped after six months because of critical increased pleural effusion. Using the multikinase inhibitor sorafenib, the disease was stabilized and an acceptable quality of life could be obtained for one year.

No MeSH data available.


Related in: MedlinePlus