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Intimal sarcoma of pulmonary artery (PAIS) is a rare disease with no characteristic symptoms. No standard therapeutic guidelines have been established so far. A 55-year-old woman who underwent pulmonary endarterectomy in 2005 with a pathological and immunohistochemical result of PAIS was re-admitted to our hospital on August 24, 2009, presenting with cough and dyspnea. The thoracic computed tomography (CT) scan revealed a 12.5 cm × 9 cm well-defined mass in the right lobe, considered a local neoplasm recurrence after a 44 month symptom-free period. As surgical resection was not proposed, she received combined chemotherapy consisting of doxorubicin, cisplatin, and ifosfamide for two cycles. Because of intolerable side effects, she received vinorelbine and cisplatin for the next four cycles. CT scans after six cycles showed remarkable regression of the tumor. After that, she began to take oral cyclophosphamide (50 mg t.i.d) everyday as a maintenance therapy. As of the time of writing, 19 months after the onset of the recurrence, she remains stable. Several antineoplastic drugs have been reported to be used in PAIS, with poor effects in most cases. To our knowledge, this is the first case of PAIS that has been successfully treated by a vinorelbine-based regimen used as second-line chemotherapy. Vinorelbine is a promising drug that may be relatively well tolerated in heavily pretreated patients with PAIS. [ABSTRACT FROM AUTHOR]

Abstract: Purposes: This study was conducted to assess the efficacy and toxicity of gefitinib as first line treatment in patients with advanced non-small-cell lung cancer (NSCLC). Methods: Tumor tissue, derived from either the original tumor or the metastatic or recurrent site was taken from chemo-naïve patients with advanced (stage IIIB, IV and recurrent) NSCLC. Tumor genomic DNA underwent direct sequencing for EGFR exons 18, 19, 20 and 21. Sixty-one patients received 250mg of gefitinib daily until disease progression or unacceptable toxicity. Results: Out of 61 patients, 26 patients (42.6%) were EGFR mutations and 11 patients were wild type, 24 patients were status unknown. One patient achieved complete remission (CR). While 17 patients achieved partial remission (PR) and 23 experienced stable disease (SD). There were 20 patients developed progressive disease (PD). The tumor response rate and disease control rate was 29.5 and 67.2%, respectively, and symptom remission rate was 66.7% as well. Median remission time was 9 days. Median over survival time was 13.0 months. Median progression-free survival time was 5.0 months. The MST of patients with EGFR mutation was 17.0 months, while the MST of patients with EGFR status unknown or wild type was 11.0 months. The PFS of patients with EGFR mutation was 9.0 months and it in EGFR status unknown or wild type was 2.5 months .The most common toxicity included rash (54.1%) and diarrhea (31.1%). Dehydration and pruritus of skin was observed in 31.1 and 26.2% of the patients respectively. Hepatic toxicity occurred in 8.2% of patients and oral ulceration occurred in six patients (9.8%). Conclusion: Single agent treatment with gefitinib is effective in patients with advanced NSCLC, especially in patients with EGFR mutation, and well tolerated in Chinese patients. [Copyright &y& Elsevier]