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Case Report

Reinitiating Chemotherapy beyond Progression after Maintenance Immunotherapy in Extensive-Stage Small-Cell Lung Cancer

by
Roxana-Andreea Rahnea-Nita
1,2,
Radu-Valeriu Toma
1,3,
Valentin Titus Grigorean
4,5,*,
Ionuţ Simion Coman
4,5,
Violeta Elena Coman
4,5,
Iancu Emil Pleşea
6,
Anwar Erchid
5,
Gabriel-Petre Gorecki
7,8 and
Gabriela Rahnea-Nita
2,9
1
8th Clinical Department—Radiology, Oncology and Hematology, Faculty of Medicine, “Carol Davila” University of Medicine and Phamacy, 020021 Bucharest, Romania
2
Department of Oncology-Palliative Care, “Sf. Luca” Chronic Diseases Hospital, 041915 Bucharest, Romania
3
Department of Radiotherapy, “Prof. Dr. Alexandru Trestioreanu” Oncological Institute, 022328 Bucharest, Romania
4
10th Clinical Department—General Surgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
5
Department of General Surgery, “Bagdasar-Arseni” Clinical Emergency Hospital, 041915 Bucharest, Romania
6
Department of Histopathology, “Bagdasar-Arseni Clinical Emergency Hospital”, 041915 Bucharest, Romania
7
Department of Anesthesia and Intensive Care, Faculty of Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
8
Department of Anesthesia and Intensive Care, CF2 Clinical Hospital, 011464 Bucharest, Romania
9
Specific Disciplines Department, Faculty of Nursing and Midwifery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
*
Author to whom correspondence should be addressed.
Medicina 2024, 60(8), 1225; https://doi.org/10.3390/medicina60081225 (registering DOI)
Submission received: 10 July 2024 / Revised: 25 July 2024 / Accepted: 26 July 2024 / Published: 28 July 2024

Abstract

Introduction: Small-cell lung cancer (SCLC) is an aggressive form of cancer with a poor prognosis. The two-year survival rate is 8% of all cases. Case presentation: We present the case of a male patient who was 50 years old at the time of diagnosis in May 2022. He was diagnosed with extensive-stage small-cell lung cancer, treated with immunotherapy in combination with chemotherapy (Durvalumab in combination with Etoposide plus Carboplatin) as a first-line treatment, followed by maintenance immunotherapy. In December 2023, a PET-CT scan revealed progressive disease with multiple metastases. Chemotherapy was reinitiated with Etoposide plus Cisplatin in January 2024. After two cycles of chemotherapy, the patient developed post-chemotherapy anemia, for which treatment with Epoetinum alpha was initiated. Chemotherapy was continued for another five cycles, until May 2024, with the maintenance of hemoglobin at a level within 9.9 mg/dL–11 mg/dL. Upon assessment at the end of May 2024, the patient presented an ECOG = 2 performance status, with a moderate general state, moderate-intensity fatigue, no pain, no anxiety or depression and no dyspnea. Discussions, Literature Review and Conclusions: Reinitiating chemotherapy after the failure of maintenance immunotherapy may be an option in patients with SCLC. Epoetinum allows oncological treatment by preventing chemotherapy-induced anemia.
Keywords: small-cell lung cancer; first-line immunotherapy; reinitiating chemotherapy; Epoetinum alpha small-cell lung cancer; first-line immunotherapy; reinitiating chemotherapy; Epoetinum alpha

Share and Cite

MDPI and ACS Style

Rahnea-Nita, R.-A.; Toma, R.-V.; Grigorean, V.T.; Coman, I.S.; Coman, V.E.; Pleşea, I.E.; Erchid, A.; Gorecki, G.-P.; Rahnea-Nita, G. Reinitiating Chemotherapy beyond Progression after Maintenance Immunotherapy in Extensive-Stage Small-Cell Lung Cancer. Medicina 2024, 60, 1225. https://doi.org/10.3390/medicina60081225

AMA Style

Rahnea-Nita R-A, Toma R-V, Grigorean VT, Coman IS, Coman VE, Pleşea IE, Erchid A, Gorecki G-P, Rahnea-Nita G. Reinitiating Chemotherapy beyond Progression after Maintenance Immunotherapy in Extensive-Stage Small-Cell Lung Cancer. Medicina. 2024; 60(8):1225. https://doi.org/10.3390/medicina60081225

Chicago/Turabian Style

Rahnea-Nita, Roxana-Andreea, Radu-Valeriu Toma, Valentin Titus Grigorean, Ionuţ Simion Coman, Violeta Elena Coman, Iancu Emil Pleşea, Anwar Erchid, Gabriel-Petre Gorecki, and Gabriela Rahnea-Nita. 2024. "Reinitiating Chemotherapy beyond Progression after Maintenance Immunotherapy in Extensive-Stage Small-Cell Lung Cancer" Medicina 60, no. 8: 1225. https://doi.org/10.3390/medicina60081225

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