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Fulltext A case of remarkable response to atezolizumab in ALK-translocated metastatic lung adenocarcinoma

Von CE, Fuang HG

Respir Med Case Rep, 2021;34:101478.
PMID: 34336591 DOI: 10.1016/j.rmcr.2021.101478

The development of resistance to tyrosine kinase inhibitors (TKIs) in metastatic non-small cell lung cancer (NSCLC) with oncogenic driver mutations highlights the challenge in improving the survival of these patients. The standard of care for ALK-rearranged advanced NSCLC refractory to various generations of ALK TKIs falls back to the use of chemotherapy and the prognosis remains poor. We report the case of a 41-year-old lady with an ALK-translocated metastatic lung adenocarcinoma, who demonstrated good response to an immune checkpoint inhibitor, atezolizumab in combination with bevacizumab and chemotherapy (pemetrexed and carboplatin), following disease progression on three generations of ALK TKIs. Six months into treatment, she continues to show improvement in her health-related quality of life and is tolerating treatment well. Our case suggests that this treatment regimen is a potential treatment option for TKI-refractory driver-mutated NSCLC.
Fulltext Introducing a Novel Method of Patella Tendon Defunctioning using Suture Anchors after a Tibial Tuberosity Avulsion Repair: Report of Three Cases

Cheong E, Tan L

Malays Orthop J, 2021 Jul;15(2):159-162.
PMID: 34429837 DOI: 10.5704/MOJ.2107.023

Tibial tuberosity avulsion injuries are rare and result from direct trauma to the tibial tuberosity or forceful and repetitive contraction of the quadriceps muscles. In this case series, we describe a novel method of defunctioning the patella tendon using a suture anchor after a tibial tuberosity avulsion fracture repair was performed. We present three consecutive patients with tibial tuberosity avulsion fractures who were treated by the same surgeon using the technique described. Pre and post-operative range of motion of the knee joint were then reviewed retrospectively. All patients achieved pre-injury range of motion within three months post-operatively. In conclusion, defunctioning the patellar tendon with a suture anchor is a reliable and reproducible technique. The new technique yielded excellent functional outcomes which allowed patients to regain their pre-injury range of motion and the strength of the construct allows early range of motion.
Fulltext Dual HER2 blockade with lapatinib and trastuzumab in combination with chemotherapy in metastatic gastroesophageal adenocarcinoma

Cheong EV, Ho GF

Clin Case Rep, 2021 Apr;9(4):2264-2268.
PMID: 33936677 DOI: 10.1002/ccr3.4009

The development of resistance to trastuzumab in HER2-positive gastroesophageal cancer remains a problem. The use of dual HER2 blockade to overcome this is a therapeutic strategy that should be researched more extensively.
A case of nasopharyngeal carcinoma and precious pregnancy

Abdul Satar NF, Cheong EV, Jasmin LPY, Ngu MR

Med J Malaysia, 2020 11;75(6):738-741.
PMID: 33219188

Cancer during pregnancy is a rare condition. We report here a case of a lady diagnosed with nasopharyngeal carcinoma (NPC) at University of Malaya Medical Centre during her first pregnancy conceived via In Vitro Fertilisation (IVF). A multidisciplinary (MDT) meeting among Oncology, Obstetrics, Rheumatology and Otolaryngology teams was conducted to discuss her treatment options. She opted for treatment with Complementary and Alternative Medicine (CAM). This case illustrates the unique challenges in the oncological management of a patient diagnosed with NPC during pregnancy. It also serves as a reminder that the use of CAM in cancer patients is prevalent. It is important for doctors to inquire about use of CAM and to be well-informed about it. Transparent communication and taking cognizance of the goals and concerns of the patients are essential in delivering patient-centred care.
Asia Pacific Gastroesophageal Cancer Congress (APGCC) 2024 consensus statement on stage 2 and 3 locally advanced gastric and Siewert 3 junctional adenocarcinoma

Masuda Y, Fong KL, Yeo D, Yeo C, Chue KM, Araba SB, et al.

J Gastroenterol, 2025 Sep;60(9):1079-1090.
PMID: 40514519 DOI: 10.1007/s00535-025-02266-4

BACKGROUND: While the development in multimodal therapies has helped improve treatment outcomes for patients with locally advanced gastric adenocarcinoma (LAGC), there still exist disparities in opinion with an optimal treatment plan. This consensus hopes to provide clinicians with structured guidelines to aid in the decision-making for treatment options for LAGC.
METHODS: The consensus statement was initiated by establishing a taskforce in collaboration with the Asia Pacific Gastroesophageal Cancer Congress (APGCC) and a multidisciplinary expert panel was selected. Clinical questions on LAGC where perceived variance in practice or opinion may exist were formulated. Studies involving patients with Stage 2 or 3 gastric or Siewert 3 junctional cancers with treatment arms of perioperative chemotherapy, neoadjuvant chemotherapy, adjuvant chemotherapy, immunotherapy and surgery were included. A total of two rounds of voting were performed. Consensus was determined to be reached when a single answer or a combination of either "strongly agree/agree" or "strongly disagree/disagree" responses exceeded 75%.
RESULTS: A total of thirteen clinical questions were developed. They were identified through five main categories: Distal LAGC, Proximal LAGC, Deficient mismatch repair tumors, Chemotherapy and Immunotherapy, and Elderly/Unfit patients. After two rounds of voting by our multidisciplinary expert panel, eleven out of a total thirteen clinical questions had reached consensus. No consensus was reached for two clinical questions.
CONCLUSION: The APGCC consensus statement aims to guide clinicians in the treatment options for LAGC and Siewert 3 junctional cancer and has clarified some of the roles of perioperative chemotherapy and immunotherapy.