Gallbladder cancer with EGFR mutation and its response to GemOx with erlotinib: a case report and review of literature

Abstract Background Gallbladder cancer (GBC) is the most common and aggressive extra hepatic biliary tree cancer (BTC) with dismal outcome. Complete surgical resection is the treatment of choice. Chemotherapy is used for palliation in advanced GBC where surgery is not possible, and the most commonly...

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Main Authors: Kishan Soni, Tarun Kumar, Manoj Pandey
Format: Article
Language:English
Published: BMC 2020-07-01
Series:World Journal of Surgical Oncology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12957-020-01934-4
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spelling doaj-a02d2103855a45b89e4911c9c5fc88e12020-11-25T02:33:58ZengBMCWorld Journal of Surgical Oncology1477-78192020-07-011811510.1186/s12957-020-01934-4Gallbladder cancer with EGFR mutation and its response to GemOx with erlotinib: a case report and review of literatureKishan Soni0Tarun Kumar1Manoj Pandey2Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu UniversityDepartment of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu UniversityDepartment of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu UniversityAbstract Background Gallbladder cancer (GBC) is the most common and aggressive extra hepatic biliary tree cancer (BTC) with dismal outcome. Complete surgical resection is the treatment of choice. Chemotherapy is used for palliation in advanced GBC where surgery is not possible, and the most commonly used agent is gemcitabine in combination with cisplatin or oxaliplatin or with capecitabine regimens. Complete remissions are hardly encountered in these cases; therefore, it is important to combine standard therapies with molecular targeting. Case presentation A 60-year-old woman presented with pain in abdomen and loss of appetite for 1 month, and imaging showed locally advanced gallbladder carcinoma with liver metastasis. After biopsy confirmation, patient was initially started on gemcitabine and oxaliplatin combination followed by gene sequencing, which showed Tp53 (exon 7—c.713 G > A and exon 5—c.376-2A > G) and EGFR (exon 20—T790M) mutation, and erlotinib was added to chemotherapy, after 6 cycles of chemotherapy patient showed a 90% partial radiological response as per RECIST criteria. Conclusion This case reports the possible efficacy of erlotinib in combination with gemcitabine and oxaliplatin in treating an EGFR-mutated GBC with liver metastasis. To our knowledge, this is the first article reporting the response to erlotinib combination therapy with this particular solitary mutation.http://link.springer.com/article/10.1186/s12957-020-01934-4Gallbladder cancerTyrosine kinase inhibitorsGemcitabineErlotinibChemotherapy
collection DOAJ
language English
format Article
sources DOAJ
author Kishan Soni
Tarun Kumar
Manoj Pandey
spellingShingle Kishan Soni
Tarun Kumar
Manoj Pandey
Gallbladder cancer with EGFR mutation and its response to GemOx with erlotinib: a case report and review of literature
World Journal of Surgical Oncology
Gallbladder cancer
Tyrosine kinase inhibitors
Gemcitabine
Erlotinib
Chemotherapy
author_facet Kishan Soni
Tarun Kumar
Manoj Pandey
author_sort Kishan Soni
title Gallbladder cancer with EGFR mutation and its response to GemOx with erlotinib: a case report and review of literature
title_short Gallbladder cancer with EGFR mutation and its response to GemOx with erlotinib: a case report and review of literature
title_full Gallbladder cancer with EGFR mutation and its response to GemOx with erlotinib: a case report and review of literature
title_fullStr Gallbladder cancer with EGFR mutation and its response to GemOx with erlotinib: a case report and review of literature
title_full_unstemmed Gallbladder cancer with EGFR mutation and its response to GemOx with erlotinib: a case report and review of literature
title_sort gallbladder cancer with egfr mutation and its response to gemox with erlotinib: a case report and review of literature
publisher BMC
series World Journal of Surgical Oncology
issn 1477-7819
publishDate 2020-07-01
description Abstract Background Gallbladder cancer (GBC) is the most common and aggressive extra hepatic biliary tree cancer (BTC) with dismal outcome. Complete surgical resection is the treatment of choice. Chemotherapy is used for palliation in advanced GBC where surgery is not possible, and the most commonly used agent is gemcitabine in combination with cisplatin or oxaliplatin or with capecitabine regimens. Complete remissions are hardly encountered in these cases; therefore, it is important to combine standard therapies with molecular targeting. Case presentation A 60-year-old woman presented with pain in abdomen and loss of appetite for 1 month, and imaging showed locally advanced gallbladder carcinoma with liver metastasis. After biopsy confirmation, patient was initially started on gemcitabine and oxaliplatin combination followed by gene sequencing, which showed Tp53 (exon 7—c.713 G > A and exon 5—c.376-2A > G) and EGFR (exon 20—T790M) mutation, and erlotinib was added to chemotherapy, after 6 cycles of chemotherapy patient showed a 90% partial radiological response as per RECIST criteria. Conclusion This case reports the possible efficacy of erlotinib in combination with gemcitabine and oxaliplatin in treating an EGFR-mutated GBC with liver metastasis. To our knowledge, this is the first article reporting the response to erlotinib combination therapy with this particular solitary mutation.
topic Gallbladder cancer
Tyrosine kinase inhibitors
Gemcitabine
Erlotinib
Chemotherapy
url http://link.springer.com/article/10.1186/s12957-020-01934-4
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AT tarunkumar gallbladdercancerwithegfrmutationanditsresponsetogemoxwitherlotinibacasereportandreviewofliterature
AT manojpandey gallbladdercancerwithegfrmutationanditsresponsetogemoxwitherlotinibacasereportandreviewofliterature
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