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Case Reports

Ampullary carcinoma is a rare type of tumor that arises from the ampulla of Vater, otherwise known as the hepatopancreatic ampulla.
Fulvestrant and palbociclib are each approved for the treatment of HR-positive metastatic breast cancer, and can also be used in combination. Cases of hepatotoxicity and elevated liver enzymes have been documented with each agent when used as monotherapy.
High-dose methotrexate is an integral component of treatment regimens for a variety of pediatric malignancies, including osteosarcoma, acute lymphoblastic leukemia, and non-Hodgkin lymphoma.
Nivolumab is now approved for every 4-week dosing. Nivolumab 480-mg dosing may have led to a more severe case of transaminitis than the every 2-week dosing in this patient with non–small-cell lung cancer, who had severe transaminitis 21 days after administration of the first dose. The steroid-refractory nature of this patient’s transaminitis, and the unclear current recommendations for infection prophylaxis, complicated the management of this patient’s autoimmune reaction.
Scleroderma is a condition in which chronic inflammation and immune effects in the tissue lead to fibrotic changes caused by excess collagen and potentially vascular damage in the skin.1,2 These immunologic changes lead to a hardening and thickening of various depths of the skin, which may have profound effects on a patient’s quality of life and requires complex medical management.
Paclitaxel is a taxane-derived antineoplastic agent that is often used for US Food and Drug Administration (FDA)-approved indications such as breast cancer, AIDS-related Kaposi sarcoma, ovarian cancer, and non–small-cell lung cancer (NSCLC).1 It is also widely used for a number of off-label indications, and it works by promoting the assembly of microtubules, further enhancing the inhibition of cellular replication. It is administered as an intravenous (IV) solution, and its dosage and duration of treatment vary based on the indication.1 Patients with high-risk breast cancer in the preoperative or the adjuvant setting can receive either dose-dense paclitaxel (ie, 175 mg/m2 every 2 weeks for 4 cycles) or weekly paclitaxel (ie, 80 mg/m2 weekly for 12 weeks). In breast cancer, paclitaxel can be administered after the use of an anthracycline, in combination with cyclophosphamide.
The European Society for Medical Oncology-European Oncology Nursing Society (ESMO-EONS) defines extravasation as the unintended leakage of a substance into the subcutaneous or subdermal tissue around the intravenous or intra-arterial administration site.
Recognizing the difference between “self” and “nonself” is a crucial role of the immune system; to regulate this recognition process, the immune system uses complex pathways, including several immune checkpoints. Recent understanding of these checkpoints, and how they affect T-cell activation, has led to therapeutic targets for cancer treatment.
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