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Takada K, et al. Pneumothorax as an Adverse Event in Patients with Lung Metastasis of Soft Tissue Sarcoma under Eribulin Treatment. Internal Medicine 58: 3009-3012, No. 20, 15 Oct 2019. Available from: URL: http://doi.org/10.2169/ internalmedicine.2790-19 - Japan 803438510

Various toxicities: 2 case reports In a report, a 34-year-old man was described, who developed severe bone marrow suppression in the form of neutropenia, anaemia and febrile neutropenia during treatment with trabectedin for a refractory metastatic synovial sarcoma of the left leg. Additionally, he developed a massive bleeding at the primary site during treatment with pazopanib and bilateral spontaneous pneumothorax during treatment with eribulin for a refractory metastatic synovial sarcoma of the left leg. A 74-year-old woman was also described, who developed right-side pneumothorax during treatment with eribulin for metastatic undifferentiated pleomorphic sarcoma of the left femoral [routes and dosages not stated; not all durations of treatments to reactions onsets and outcomes stated]. Patient 1: The 34-year-old man presented with refractory synovial sarcoma of the left leg with metastases to liver, bone and lung. One year prior to presentation, he had been diagnosed with synovial sarcoma of the left leg with multiple bilateral lung metastases. Initially, he had received doxorubicin and ifosfamide; however, after 3 courses, disease progression was observed in the form of lung metastases. Hence, he had started receiving trabectedin as second-line treatment. After six courses of trabectedin, a partial response was observed according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. However, he developed trabectedinassociated severe bone marrow suppression in the form of anaemia, grade 4 neutropenia and grade 3 febrile neutropenia. As a result, trabectedin was replaced by pazopanib, a third-line chemotherapy. However, a massive bleeding at the primary site was observed due to pazopanib. To continue the systemic therapy and to avoid bleeding, his left leg was amputated, including the primary tumour site. After amputation, his bilateral lung metastases rapidly progressed. Multiple bone metastases manifested, accompanied by severe back pain and paralysis of both legs, along with bladder and rectal disturbances. To improve his neurogenic pain and other disorders that originated from the bone metastases, he received radiation at the sacral bone. Thereafter, as a fourthline therapy, he started receiving eribulin. On the 10th day of eribulin treatment, he developed dyspnoea and chest pain. A chest x-ray showed simultaneous bilateral spontaneous pneumothorax. He underwent bilateral drainage of the thoracic cavity. However, after 2 weeks, he died due to progression of the metastatic synovial sarcoma. Patient 2: The 74-year-old woman was diagnosed with left femoral undifferentiated pleomorphic sarcoma (UPS) 3 years prior. Initially, she had received neo-adjuvant chemotherapy (NAC) with doxorubicin and ifosfamide. After 3 cours