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Medical Oncology

Thomas D Canale, HyoKeun Cho, Winson Y Cheung
Given the significant morbidity burden associated with advanced pancreatic cancer (APC), its management is complex and frequently requires multidisciplinary care. Because of potential geographical barriers to healthcare access, we aimed to determine the effect of rurality on management and outcomes of APC patients. Patients diagnosed with APC from 2008 to 2015 and received Gemcitabine (Gem), Gemcitabine plus nab-Paclitaxel (Gem/Nab), or FOLFIRINOX at any 1 of 6 British Columbia cancer centers across the province were reviewed...
July 4, 2018: Medical Oncology
A E Quinton, S H Gwynne, K L Yim
The prognosis of pancreatic cancer remains very poor, with a 5-year survival rate of around 3%. There has been little impact from various chemotherapy regimens on improving outcome for several decades. Gemcitabine has been the mainstay chemotherapy for around two decades with little improvement in overall survival (OS) for patients with advanced disease. However, more recently, there has been a paradigm shift in treatment options for these patients. Reported in 2011, combination therapy with FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, and fluorouracil) showed a long awaited but modest improvement in survival, but is reserved only for a small proportion of very fit patients due to concerns over its toxicities...
July 2, 2018: Medical Oncology
Arkhjamil Angeles, Wayne Hung, Winson Y Cheung
The CORRECT trial demonstrated survival benefits with regorafenib monotherapy in patients with treatment-refractory, metastatic colorectal cancer (mCRC). However, the trial's stringent eligibility criteria for regorafenib may limit its external validity. We aimed to examine treatment attrition rates and eligibility for regorafenib in routine practice. We identified patients at the British Columbia Cancer Agency diagnosed with mCRC who demonstrated disease progression or intolerable toxicity on 2 or more lines of systemic therapy...
June 23, 2018: Medical Oncology
Albert J Farias, Wen-Hsing Wu, Xianglin L Du
The purpose of the study is to examine disparities in AET adherence and discontinuation among Texas Medicaid-insured early-stage breast cancer patients. Texas Cancer Registry Medicaid-linked database was used from 2000 to 2007 for breast cancer patients aged 20-64. Multivariable logistic regression was performed to test the association of race/ethnicity and geographic factors with AET adherence and discontinuation. Of the 1240 women with breast cancer, 60.8% of non-Hispanic white vs 46.6% of Black patients were adherent to AET in the first year...
June 20, 2018: Medical Oncology
Michela Roberto, Andrea Botticelli, Lidia Strigari, Michele Ghidini, Concetta Elisa Onesti, Margherita Ratti, Ilaria Benzoni, Claudio Pizzo, Rosa Falcone, Daniele Lomiento, Bianca Maria Donida, Luigi Totaro, Federica Mazzuca, Paolo Marchetti
This study aimed to identify clinicopathological factors associated with the outcome of elderly patients with gastric cancer (GC), and to construct a nomogram for individual risk prediction. Tumor characteristics of 143 patients aged ≥ 80 years underwent surgery for GC were collected and analyzed by uni- and multivariate analyses. A prognostic nomogram was constructed using the factors which resulted to be significantly associated with overall survival. Discrimination of nomogram was tested by Kaplan-Meier (KM) curves and boxplots...
June 19, 2018: Medical Oncology
Valeria Romeo, Brigida Iorio, Massimo Mesolella, Lorenzo Ugga, Francesco Verde, Emanuele Nicolai, Mario Covello
The purpose of the study was to assess by simultaneous positron emission tomography/magnetic resonance imaging (PET/MRI) the response to chemotherapy (CHT) and/or radiotherapy (RT) in patients with head and neck squamous cell carcinoma (HNSCC). Five patients with HNSCC underwent simultaneous PET/MRI examination before and after CHT and/or RT. Standard uptake volume (SUV), apparent diffusion coefficient (ADC), Ktrans, Kep, Ve, and iAUC pre- and post-treatment values were extracted and compared. The response to treatment was assessed according to RECIST criteria and classified as complete response (CR), partial response (PR), stable disease (SD), and progression disease (PD)...
June 19, 2018: Medical Oncology
Davis Sam, Gillian Gresham, Omar Abdel-Rahman, Winson Y Cheung
Results from novel therapeutics trials are not always generalizable to real-world patients. We aimed to determine the pattern in which trial findings are applied in a population-based setting of melanoma patients and consequent treatment outcomes. Patients with unresectable disease during 2011-2014 and referred to cancer centers in a large Canadian province were retrospectively reviewed. Based on eligibility criteria as described in registration trials of vemurafenib (Vem) and ipilimumab (Ipi), we classified patients into trial-eligible and ineligible and those treated and untreated with these agents...
June 18, 2018: Medical Oncology
Andrew C Tiu, Rashmika Potdar, Djeneba Audrey Djibo, Muhammad Masab, Claudia Dourado
African Americans (AA) have the highest incidence and mortality rates with lung cancer. They are diagnosed at an earlier age with more advanced disease. Programmed cell death protein-1 inhibitor, Nivolumab, was approved as a second-line agent after failure of platinum-based therapy for advanced or metastatic non-small cell lung cancer (NSCLC). The original studies leading to the approval of Nivolumab had insufficient AA patients, thus there is still inadequate knowledge on treatment outcomes among AA patients...
June 18, 2018: Medical Oncology
Koji Nishimoto, Masato Karayama, Naoki Inui, Hideki Yasui, Hironao Hozumi, Yuzo Suzuki, Kazuki Furuhashi, Tomoyuki Fujisawa, Noriyuki Enomoto, Yutaro Nakamura, Nao Inami, Shun Matsuura, Yusuke Kaida, Takashi Matsui, Kazuhiro Asada, Hiroyuki Matsuda, Masato Fujii, Mikio Toyoshima, Shiro Imokawa, Takafumi Suda
Switch maintenance therapy, using alternative agents that were not administered during induction chemotherapy, is a treatment option for advanced non-squamous non-small cell lung cancer (NSCLC). Bevacizumab is known to increase the efficacy of other chemotherapeutic agents; however, switch maintenance therapy with docetaxel and bevacizumab has not been adequately studied. The goal of this study was to evaluate the efficacy and safety of switch maintenance therapy with docetaxel and bevacizumab following induction therapy with cisplatin, pemetrexed, and bevacizumab...
June 16, 2018: Medical Oncology
Michela Dispinzieri, Eliana La Rocca, Elisabetta Meneghini, Alba Fiorentino, Laura Lozza, Serena Di Cosimo, Massimiliano Gennaro, Vito Cosentino, Milena Sant, Emanuele Pignoli, Riccardo Valdagni, Francesca Bonfantini, Maria Carmen De Santis
The purpose of the study was to examine adherence to hormone therapy (HT) in elderly breast cancer patients (≥ 65 years old) treated with hypofractionated radiotherapy. We analyzed data on 550 ER-positive breast cancer patients given hypofractionated whole-breast radiotherapy from June 2009 to September 2016. Baseline comorbidities considered in the hypertension-augmented Charlson Comorbidity Index (hCCI) were retrospectively retrieved. Total hCCI scores were classified as no comorbidity (hCCI = 0), low burden of comorbidity (hCCI = 1), and high burden of comorbidity (hCCI ≥ 2)...
June 16, 2018: Medical Oncology
Matthias Villalobos, Piotr Czapiewski, Niels Reinmuth, Jürgen R Fischer, Stefan Andreas, Cornelius Kortsik, Monika Serke, Martin Wolf, Petra Neuser, Alexander Reuss, Philipp A Schnabel, Michael Thomas
Prior studies have demonstrated an association between excision repair cross-complementation group 1 (ERCC1) expression level and outcomes in patients with advanced non-small cell lung cancer (NSCLC) treated with platinum-based chemotherapy. The aim of this study was to assess the impact of ERCC1 on survival for patients with stage IIIB/IV non-squamous NSCLC (NS-NSCLC) enrolled in the INNOVATIONS trial, thus receiving as treatment either erlotinib/bevacizumab (EB) or cisplatin/gemcitabine/bevacizumab (PGB)...
June 15, 2018: Medical Oncology
Kejun Cheng, Xi Liu, Lu Chen, Jian-Min Lv, Fa-Jun Qu, Xiu-Wu Pan, Lin Li, Xin-Gang Cui, Yi Gao, Dan-Feng Xu
Prostate cancer (PCa) is one of the most commonly diagnosed urological malignancies. However, there are limited therapies for PCa patients who develop biochemical recurrence after androgen deprivation therapy (ADT). In the present study, we investigated the therapeutic efficacy and mechanism of α-Viniferin (KCV), an oligostilbene of trimeric resveratrol, against human PCa cells and found that it markedly inhibited the proliferation of LNCaP, DU145, and PC-3 cancer cells in a time- and dose-dependent manner, and had a strong cytotoxicity in non-androgen-dependent PCa cells...
June 15, 2018: Medical Oncology
Yuji Konishi, Futoshi Kawamata, Hiroshi Nishihara, Shigenori Homma, Yasutaka Kato, Masumi Tsuda, Shinji Kohsaka, Takahiro Einama, Cheng Liu, Tadashi Yoshida, Akihisa Nagatsu, Mishie Tanino, Shinya Tanaka, Hideki Kawamura, Toshiya Kamiyama, Akinobu Taketomi
Tumor budding is thought to represent a manifestation of epithelial-to-mesenchymal transition (EMT) and it has been correlated with poor patient outcomes in colorectal cancer (CRC). Our group recently demonstrated that human chorionic gonadotropin-β (hCGβ) modulates EMT in CRC. In the current study, based on the likely relationships between tumor budding and hCGβ expression, we examined their clinicopathologic significance in CRC. Twenty-eight of 80 (35.0%) CRC showed tumor budding. Tumor budding significantly correlated with lymph node metastasis (P < 0...
June 11, 2018: Medical Oncology
Oliver Schnell, Valerie Albrecht, David Pfirrmann, Sabina Eigenbrod, Bjarne Krebs, Alexander Romagna, Sebastian Siller, Armin Giese, Jörg-Christian Tonn, Christian Schichor
Integrin alpha-v-beta-3 (αv β3 ) is important for invasive tumor growth and angiogenesis in glioblastomas (GBM). However, recent clinical trials on inhibition of this integrin led to ambiguous results whether patients with methylated or unmethylated 6 O-methylguanine methyltransferase (MGMT) promoter might profit from this kind of therapy. Therefore, we addressed the still unanswered question about a possible correlation between integrin αv β3 expression and MGMT promoter methylation in GBM. For this purpose, tumor samples from newly diagnosed and untreated GBM patients with methylated (n = 22) or unmethylated (n = 17) MGMT promoter were simultaneously analyzed for integrin αv β3 expression by an automated immunohistochemical staining platform...
June 7, 2018: Medical Oncology
Ala Eddin S Sagar, Carlos A Jimenez, Vickie R Shannon
Inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm that may arise in soft tissues of nearly every organ. Although IMTs are the most common lung tumors in pediatric populations, these tumors are extremely rare in adults, constituting less than 1% of adult lung tumors. IMTs are characterized by proliferating spindle cells with variable inflammatory component. The biological behavior of lung IMTs in adults is highly unpredictable, which confounds diagnosis and treatment. We retrospectively investigated patients with pulmonary lesions and the histopathologic diagnosis of inflammatory myofibroblastic tumor or its synonymous names (Plasma Cell Granuloma, xanthogranuloma, inflammatory pseudotumor, fibroxanthoma, and fibrous histiocytoma) at the MD Anderson Cancer Institute in the period between August 2000 and August 2016...
June 4, 2018: Medical Oncology
George Papaxoinis, Vassiliki Kotoula, Eleni Giannoulatou, Georgia-Angeliki Koliou, Vasilios Karavasilis, Sotirios Lakis, Andreas Koureas, Mattheos Bobos, Elpida Chalaralambous, Emily Daskalaki, Kyriakos Chatzopoulos, George Tsironis, Elisavet Pazarli, Sofia Chrisafi, Epaminontas Samantas, Ioannis G Kaklamanos, Ioannis Varthalitis, Athina Konstantara, Konstantinos N Syrigos, George Pentheroudakis, Dimitrios Pectasides, George Fountzilas
This clinical trial assessed the efficacy and toxicity of panitumumab combined with oxaliplatin and capecitabine as first-line treatment in KRAS exon 2 wild-type metastatic colorectal cancer (mCRC) patients. Patients with exon 2 KRAS wild-type mCRC received panitumumab 9 mg/Kg, oxaliplatin 130 mg/m2 , and capecitabine 2000 mg/m2 repeated every 3 weeks. The primary endpoint was objective response rate (ORR, minimum 42 responses). We retrospectively assessed mutations in genes implicated in CRC with massively parallel sequencing; ERBB2 and EGFR amplification with fluorescence in situ hybridization, and tumor-infiltrating lymphocyte density...
May 31, 2018: Medical Oncology
Kei Saito, Hiroyuki Isayama, Yoshihiro Sakamoto, Yousuke Nakai, Kazunaga Ishigaki, Mariko Tanaka, Takeyuki Watadani, Junichi Arita, Naminatsu Takahara, Suguru Mizuno, Hirofumi Kogure, Hideaki Ijichi, Keisuke Tateishi, Minoru Tada, Kiyoshi Hasegawa, Masashi Fukayama, Norihiro Kokudo, Kazuhiko Koike
There has been a pressing need to develop optimal regimen for neoadjuvant chemotherapy (NAC) for pancreatic cancer (PC). The safety and efficacy of gemcitabine, S-1, and LV combination (GSL) therapy as NAC for borderline resectable (BR) and locally advanced (LA) PC was evaluated in this phase II study. Patients with pathologically proven BR or LA PC were enrolled and gemcitabine 1000 mg/m2 by 30-min infusion on day 1, S-1 40 mg/m2 orally twice daily, and LV 25 mg orally twice daily on days 1-7 every 2 weeks were provided, and evaluation by CT every 2 courses was performed...
May 30, 2018: Medical Oncology
Tomonori Nakazato, Noriyoshi Iriyama, Michihide Tokuhira, Maho Ishikawa, Eriko Sato, Tomoiku Takaku, Kei-Ji Sugimoto, Hiroyuki Fujita, Isao Fujioka, Yuta Kimura, Yoshinobu Aisa, Eisaku Iwanaga, Norio Asou, Masahiro Kizaki, Yoshihiro Hatta, Norio Komatsu, Tatsuya Kawaguchi
We performed a retrospective study to evaluate the incidence of second malignancies (SMs) in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKIs). We analyzed data from 339 patients with CML who were extracted from the CML Cooperative Study Group database. The standardized incidence ratio (SIR) was calculated to assess the risk of SMs using data from the Cancer Registries in Japan. The median follow-up was 65 months. SMs developed in 14 patients (4.1%, 10 men, 4 women) after the start of TKIs...
May 30, 2018: Medical Oncology
Alfredo Tartarone, Rosa Lerose, Michele Aieta
Malignant pleural mesothelioma (MPM) is a very aggressive malignancy, mainly caused by asbestos exposure. Patients with MPM have a poor prognosis that remained substantially unchanged in the last few years and limited effective therapeutic options with no recognized second or further-line therapy. In this context, also in view of the positive results observed in other tumor types, immunotherapy could play a relevant role. This review focuses on the most promising immunotherapies being investigated in MPM.
May 29, 2018: Medical Oncology
Ioannis Skarmoutsos, Athanasios Skarmoutsos, Ioannis Katafigiotis, Elisavet Tataki, Athina Giagini, Ioannis Adamakis, Christos Alamanis, Mordechai Duvdevani, Nikolaos Sitaras, Constantinos Constantinides
The goal of the study is to examine the possible use of HA (hyaluronic acid) and HAase (hyaluronidase) as novel urine biomarkers for the early diagnosis for prostate cancer (Pca). After a prostatic massage, the urine of 118 high-risk patients for Pca was collected, and the patients were submitted to ultrasound-guided transrectal biopsy. HA and HAase were detected and analyzed with Enzyme-Linked Immunosorbent Assay, and a statistical analysis of the urine levels of the two biomarkers according to the histology results was performed...
May 25, 2018: Medical Oncology
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