RESUMEN

•First report of a secondary somatic glioblastoma arising from MCT-MT in a patient with underlying Li-Fraumeni syndrome.•The rarity of glioblastoma arising from MCT-MT warrants investigation for underlying genetic predisposition.•Glioblastomas arising from MCT-MT appear to exhibit wild type IDH gene status.•Advanced-stage glioblastoma arising from MCT-MT exhibits aggressive behavior and requires adjuvant therapy.•Optimal adjuvant therapy regimen for glioblastoma arising from MCT-MT remains unknown.

RESUMEN

PURPOSE: Evaluate the longitudinal relationship between mammographic density and hormonal contraceptive use in late reproductive-aged women. METHODS: Patients aged 35-50 years old who underwent 5 or more screening mammograms within a 7.5-year period between 2004 and 2019 in a single urban tertiary care center were randomly selected. Patients were categorized into four cohorts based on hormonal contraceptive exposure during a 2-year lead-in period and a 7.5-year study period: 1) never exposed, 2) always exposed, 3) interval hormonal contraceptive start, and 4) interval hormonal contraceptive stop. The primary outcome was difference in BI-RADS breast density category between initial and final mammograms. RESULTS: Of the 708 patients included, long-term use of combined oral contraceptives or a levonorgestrel intrauterine device were not associated with an increase in breast density category over the 7.5-year study period, compared to those with no hormonal contraceptive exposure. Initiation of combined oral contraceptives was associated with an increase in breast density category (ß = 0.31, P = 0.045); however, no difference in initial density category was noted between those exposed and those never exposed to combined oral contraceptives during the 2-year lead-in period, and discontinuation was not associated with a decrease in breast density category when compared to those with continuous exposure. CONCLUSION(S): Long-term use of combined oral contraceptives or a levonorgestrel intrauterine device was not associated with an increase in BI-RADS breast density category. Initiation of a combined oral contraceptive was associated with an increase in breast density category, although this may be a transient effect.

Asunto(s)

Anticonceptivos Orales Combinados , Levonorgestrel , Humanos , Femenino , Adulto , Persona de Mediana Edad , Levonorgestrel/efectos adversos , Densidad de la Mama , Estudios Longitudinales , Estudios de Cohortes

RESUMEN

OBJECTIVES: To investigate the efficacy of pembrolizumab plus lenvatinib as a second-line or later-line therapy in women with advanced or recurrent uterine carcinosarcoma (UCS). METHODS: A single-institution pharmacy database was queried for women with advanced or recurrent UCS who were prescribed concurrent pembrolizumab and lenvatinib. Patient demographic, oncologic, and immunotherapy outcomes data were recorded. Univariate analysis summarized progression-free survival (PFS) and overall survival (OS). RESULTS: Seven patients with advanced or recurrent UCS were treated with combination pembrolizumab and lenvatinib, with a median age of 63.0 years. The majority had stage III or IV disease (n = 6, 85.7%) and had failed two or more lines of therapy (n = 7, 100.0%), and a minority were MMR deficient (n = 1, 14.3%) or PD-L1+ (n = 1, 14.3%). No partial or complete responses were observed. The median PFS was 2.6 months (95% CI, 0.9-11.2 months), and the median OS was 2.8 months (95% CI, 2.4-NE). CONCLUSIONS: In this small, retrospective series, we demonstrate that pembrolizumab and lenvatinib combination therapy may not be highly active in UCS and may be associated with similar PFS and OS as traditional cytotoxic regimens. Further study is warranted to assess the efficacy of this regimen in more targeted cohorts of women with advanced or recurrent UCS.