title: A novel approach using sorafenib in alpha fetoprotein-producing hepatoid adenocarcinoma of the lung.
abstract: Hepatoid adenocarcinoma of the lung (HAL) is an extremely rare cancer without clear treatment guidance and with a poor prognosis. This report discusses a 64-year-old man who presented with complaints of hemoptysis and was found to have a right upper lobe (RUL) lung mass on chest CT with presence of a right hilar mass and retrocaval lymphadenopathy, and metastasis to the vertebral spine and rib. The patient was diagnosed with T2N2M1 (stage IV) unresectable disease. A biopsy of the RUL mass revealed hepatoid variant adenocarcinoma. Immunohistochemical stains showed tumor cells positive for CK7, AFP, Hep Par 1, napsin A, and cytoplasmic TTF-1 staining. In contrast, CK5, CK6, and CK20 were negative, and EGFR was wild-type. Serum alpha fetoprotein (AFP) level was elevated at 181 ng/mL. The patient was treated with platinum-based doublet chemotherapy and sorafenib, and his AFP level decreased to 25 ng/mL. This case report presents the novel use of sorafenib in combination with platinum-based doublet chemotherapy in EGFR wild-type HAL, which led to a partial response. Single-agent sorafenib led to stable disease overall, achieving a survival among the longest reported for unresectable stage IV, all while maintaining an ECOG performance status of 0 to 1.
authors: From Icahn School of Medicine at Mount Sinai Bronx program, James J. Peters Veterans Affairs Medical Center, and Columbia University, New York, New York.
authors: Tatjana
authors: T
authors: Gavrancic
authors: From Icahn School of Medicine at Mount Sinai Bronx program, James J. Peters Veterans Affairs Medical Center, and Columbia University, New York, New York. From Icahn School of Medicine at Mount Sinai Bronx program, James J. Peters Veterans Affairs Medical Center, and Columbia University, New York, New York.
authors: Yeun-Hee Anna
authors: YH
authors: Park
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy* / Q000556:secondary; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives*; D017239:Paclitaxel / Q000008:administration & dosage; D010671:Phenylurea Compounds / Q000008:administration & dosage*; D000077157:Sorafenib; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D010671:Phenylurea Compounds; D000509:alpha-Fetoproteins; D009536:Niacinamide; D000077157:Sorafenib; D016190:Carboplatin; D017239:Paclitaxel