Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033036 (APC)
 10,214 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 44-year-old man was admitted to our hospital because of brain metastasis and intrapulmonary exacerbation of lung adenocarcinoma. Systemic chemotherapy (PAC + CBDCA) was administered, but neurological symptoms (muscle weakness of limbs and disorientation) appeared. Lumbar puncture and enhanced MRI of lumber vertebrae revealed meningeal carcinomatosis. MTX 20 mg/week (+ Ara-C 40 mg/week) was injected into the meningeal space. There was a clear improvement in the neurological symptoms, but it did not last long. Meningeal injection was performed 7 times. Whole-brain and whole-marrow radiation along with systemic chemotherapy gave a marked improvement in the symptoms and in the metastatic shadow on the chest CT scan.
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PMID:[A case of meningeal carcinomatosis from lung cancer successfully treated with aggressive multimodal therapy]. 1741 41

Jejunal carcinoma in patients with familial adenomatous polyposis has been rarely reported, and little is known about its association with genetic alterations of the APC gene. A 52-year-old woman with familial adenomatous polyposis underwent palliative resection of the proximal jejunum because of two circumferential tumors associated with peritoneal carcinomatosis. A histological examination revealed that one tumor was a poorly differentiated adenocarcinoma, and that the other was a moderately differentiated adenocarcinoma with adenomatous components. The patient did not respond to standard chemotherapy and died of disseminated disease 8 months after surgery. A genetic analysis of the APC gene identified somatic mutations in each tumor (c.4450delAG and p.R1450X) in addition to the germline mutation (c.3984del5), all of which form stop codons, resulting in truncated APC products. This report is the first description of how a second hit to the APC gene can be involved in carcinogenesis of the jejunum in familial adenomatous polyposis.
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PMID:Identification of APC gene mutations in jejunal carcinomas from a patient with familial adenomatous polyposis. 2390 6

The principal surgical complication feared in a patient under anti-angiogenic targeted therapy is gastrointestinal perforation. It is therefore important to be alert to situations "potentially at risk" of perforation: diverticulitis, carcinomatosis, intra-abdominal abscess, history of external radiotherapy, colonoscopy in the 4 weeks preceding the treatment, inflammatory disease and gastrointestinal mucosal ulceration, colonic stent, NSAID. It is essential to make an early diagnosis, and for treatment to be conservative if possible, with nasogastric aspiration without surgery. Surgical treatment is only offered in the event of worsening or failure of medical treatment. The time periods between surgery and the initiation of anti-angiogenic treatment vary according to the medication. With bevacizumab: major surgery: 4 weeks; 6 weeks if the patient has comorbidities. Minor surgery (e.g. dental extraction): wait for the wound to heal. With insertion of a PAC, bevacizumab can be administered the day after the insertion if necessary. With TKI: it is recommended to wait for the scar to heal in cases of major surgery. There is no specific recommendation for mTOR inhibitors. The time periods between termination of an anti-angiogenic treatment and scheduling of surgery also vary depending on the medication. With bevacizumab: 6 to 8 weeks for scheduled surgery. In the event of emergency surgery, the surgeon must be aware of an increased risk of post-operative complications. With TKI, 2 days for sorafenib, and 4 days for sunitinib. There is no specific recommendation for mTOR inhibitors.
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PMID:[Managing side-effects of targeted therapies in renal cancer:surgical complications]. 2581 27