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Abstract Introduction Current treatment guidelines for patients with epidermal growth factor receptor (EGFR)-mutated metastatic non-small cell lung cancer (mNSCLC) recommend EGFR tyrosine kinase inhibitors (TKIs) as the standard of care for first-line treatment, with third-generation osimertinib the preferred choice. However, most patients develop resistance to targeted therapy, and subsequent systemic chemotherapy is recommended. The aim of this study was to characterize the subsequent line of therapy (LOT) following osimertinib in patients with EGFR-mNSCLC. Methods Medical and pharmacy claims of adults who initiated a subsequent LOT (index) after initial osimertinib discontinuation between November 2015 and September 2019 were analyzed retrospectively. Results A total of 135 patients met the inclusion criteria. After metastatic diagnosis, 22.2% and 49.6% of patients were treated with osimertinib in the first and second line, respectively. After osimertinib discontinuation, most patients were treated with a platinum-based chemotherapy regimen (57%), of which 40.3% included immuno-oncology therapy. Reuse or continuation of EGFR TKIs was also common (24%). Overall, the median time to treatment discontinuation for the index LOT was 2.4 months. Proportions of patients with ≥ 1 inpatient or emergency department visit were 31.9% and 35.6%, respectively. Conclusions The duration of the LOT following osimertinib was short and associated with tolerability issues underscoring a high unmet need for new therapies to address EGFR TKI resistance.

Acute leukemias are rare disease in the neonatal period. They occur preferentially in newborns with trisomy 21. They often manifest as hepatosplenomegaly, extra-hematopoietic involvement and hyperleukocytosis. Blueberry Muffin Baby syndrome is observed in the neonatal period. Neonatal acute myeloïd leukemia (AML) is more common than acute lymphoid leukemia (ALL). Despite treatment, neonatal acute leukemias have a poor prognosis with a low percentage of overall survival. We report a case of neonatal AML on a ground of trisomy 21 revealed by a Blueberry Muffin Baby syndrome.

The authors report a case of a cutaneous infection due to Bacillus licheniformis. It occurred after a wound due to a wicker splinter. The bacteriological identification was easy thanks to the very typical aspects of culture. First intention antibiotherapy given for bacterial dermo-hypodermatitis may be ineffective because Bacillus licheniformis secretes a biofilm and is frequently resistant to Beta-lactams.