Neurokinin-1 receptor antagonist aprepitant and radiotherapy, a successful combination therapy in a patient with lung cancer: A case report.

Abstract

Lung cancer (LC) is the leading cause of cancer death and is responsible for more than one-quarter (27%) of all cancer deaths. Non-small-cell LC (NSCLC) is the main histological subtype of LC and is the leading cause of mortalities associated with cancer. This case report focused on a patient showing a history of chronic obstructive pulmonary disease (COPD) with a NSCLC squamous cell carcinoma (single mass with a diameter of 8×7 cm, without metastasis). Due to the COPD, neither a surgical treatment (pneumonectomy) nor chemotherapy was possible. After 15 days following the diagnosis, the patient was treated for 45 days with radiotherapy and the neurokinin-1 receptor, aprepitant (compassionate use, 1,140 mg/day). Radiotherapy was administered to the right lung and mediastinum, reaching 50.4 Gy and then overprinted to 65 Gy. In each successive control, the tumor volume decreased and, after 6 months of treatment, the chest computed tomography scan showed that the tumor mass had disappeared. No side-effects were observed during the combination therapy; in contrast, the patient was in very good general health with a weight gain and showing no biochemical analytical alteration. This case report suggests a witness episode to the antitumor effect of aprepitant/radiotherapy against NSCLC. Urgent development is required for clinical trials to test the combination treatment (radiotherapy and aprepitant) as an antitumor therapy for patients with LC.