Paclitaxel/trastuzumab
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Paclitaxel/trastuzumab Various toxicities: 4 case reports
In a retrospective study of 4 patients who were treated between January 2014 and August 2019, 2 men and 2 women aged 61–78 years were described, who developed neurotoxicity, cardiotoxicity in the form of ejection fraction decreased, leucopenia, neutropenia and decrease in platelet count or exhibited lack of efficacy during treatment with paclitaxel and trastuzumab for extramammary Paget’s disease [routes, durations of treatments to reactions onsets and outcomes not stated]. Case 1: A 74-year-old man developed neurotoxicity during treatment with paclitaxel and trastuzumab for extramammary Paget’s disease. The man was diagnosed with metastatic extramammary Paget’s disease with inguinal lymph nodes, liver and pulmonary metastatic lesions. His comorbidities included chronic pulmonary fibrosis, chronic respiratory failure and emphysema. His previous treatment included radiotherapy and docetaxel. The docetaxel therapy was discontinued due to exacerbation of interstitial pneumonia [aetiology not stated]. Thereafter, he started receiving trastuzumab 4 mg/kg (as loading dose) followed by trastuzumab 2 mg/kg every week along with paclitaxel 80 mg/m2 weekly. During the treatment, improvement was noted in his condition and he showed partial response. During the treatment, he developed grade I neurotoxicity related to the combination therapy. After that, he remained progression-free for 12 months. After an overall survival time of 18 months after the combination treatment, he died [immediate cause of death not stated]. Case 2: A 78-year-old woman exhibited lack of efficacy during treatment with paclitaxel and trastuzumab for extramammary Paget’s disease. The woman was diagnosed with metastatic extramammary Paget’s disease with para-aortic and inguinal lymph node and liver metastatic lesions. Her comorbidities included knee osteoarthritis and osteoporosis. She started receiving combination treatment with trastuzumab 4 mg/kg (as loading dose) followed by trastuzumab 2 mg/kg every week along with paclitaxel 80 mg/m2 weekly. However, despite the treatment, disease progression was noted after only 2 months. Investigations showed immunohistochemistry 3+ and low in situ hybridisation levels (HER2/CEP17 at less than 2.0). Hence, the combination treatment with paclitaxel and trastuzumab was discontinued. After she exhibited lack of efficacy with the combination treatment, whole brain radiotherapy was started. After an overall survival time of 4 months after the combination treatment, she died [immediate cause of death not stated]. Case 3: A 61-year-old man developed neurotoxicity and cardiotoxicity in the form of ejection fraction decreased during treatment with paclitaxel and trastuzumab for extramammary Paget’s disease. He also exhibited lack of efficacy during the treatment with paclitaxel and trastuzumab. The man was diagnosed with metastatic extramammary Paget’s disease with Para-aortic and inguinal lymph node, liver and bone metastatic lesions. His prior treatments in
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