A phase II clinical trial evaluating the safety and efficacy of durvalumab as first line therapy in advanced and metastatic non-small cell lung cancer patients with Eastern Cooperative Oncology Group performance status of 2.

Background: Approximately 30-40% of patients with advanced and metastatic non-small cell lung cancer (NSCLC) present with an impaired performance status (PS). There are limited prospective data on the safety and efficacy of durvalumab in these patients.

Methods: In this single-arm phase II clinical trial (NCT02879617), patients with previously untreated Stage IIIB/IV NSCLC and ECOG PS of 2 received durvalumab 1500 mg every 28 days until progression or unacceptable toxicity.

Successful management of life-threatening hemorrhage in a patient with synchronous lupus anticoagulant and factor VIII inhibitor.

Acquired factor VIII inhibitor is increasingly recognized as a cause of major soft tissue hemorrhage. The laboratory diagnosis can be obscured by the synchronous presence of the lupus anticoagulant, an extremely rare occurrence that has been reported outside the vascular surgery literature. Vascular surgeons should be knowledgeable of factor VIII inhibitor and aware that it can present with other blood disorders, making the diagnosis more difficult and management more complex.