title: Synchronous double primary lung cancers with different response to pemetrexed.
abstract: We describe the case of a 74-year-old male patient with synchronous double primary lung cancers: adenocarcinoma in the right lower lobe and squamous cell carcinoma in the left upper lobe (LUL). These tumors were difficult to differentiate radiographically from a single metastatic primary cancer, but their eventual diagnoses were triggered by their responses to chemotherapy, which included pemetrexed. After two courses of chemotherapy with pemetrexed and carboplatin, the right lower lobe mass had partially resolved; however, the LUL mass had increased. When S-1 was used as fourth-line chemotherapy, the size of the LUL mass decreased. Pemetrexed is a potentially useful drug for treating nonsquamous cell carcinoma, but may not be appropriate in cases with a coexisting squamous cell carcinoma. Our experience with this interesting case leads us to propose that S-1 monotherapy may provide a treatment option in pemetrexed-refractory cases.
authors.affiliation: Department of Clinical Oncology, Sumitomo-Besshi Hospital, Niihama, Japan. ume-fuji@nifty.com
authors.forename: Shigeki
authors.initials: S
authors.lastname: Umemura
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Yamane
authors.forename: Takuya
authors.initials: T
authors.lastname: Yano
authors.forename: Toshiko
authors.initials: T
authors.lastname: Hoshika
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shiote
authors.forename: Nagio
authors.initials: N
authors.lastname: Takigawa
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Suwaki
authors.forename: Atsuko
authors.initials: A
authors.lastname: Shirakawa
authors.forename: Haruhito
authors.initials: H
authors.lastname: Kamei
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D004338:Drug Combinations; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy* / Q000473:pathology; D010094:Oxonic Acid / Q000008:administration & dosage; D000068437:Pemetrexed; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D005971:Glutamates; D000068437:Pemetrexed; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D006147:Guanine; D016190:Carboplatin