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https://www.readbyqxmd.com/read/29222306/therapy-of-primary-cns-lymphoma-role-of-intensity-radiation-and-novel-agents
#1
REVIEW
Andrés José María Ferreri
Primary central nervous system (CNS) lymphomas represent a subgroup of malignancies with specific characteristics, an aggressive course, and unsatisfactory outcome in contrast with other lymphomas comparable for tumor burden and histological type. Despite the high sensitivity to conventional chemotherapy and radiotherapy, remissions are frequently short lasting. Treatment efficacy is limited by several factors, including the biology and microenvironment of this malignancy and the "protective" effect of the blood-brain barrier, which limits the access of most drugs to the CNS...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221876/conventional-versus-hypofractionated-radiation-therapy-for-localized-prostate-cancer-a-meta-analysis-of-randomized-noninferiority-trials
#2
REVIEW
Trevor Joseph Royce, Dong Hoon Lee, NaNa Keum, Nitipong Permpalung, Calvin J Chiew, Sherise Epstein, Kristen M Pluchino, Anthony V D'Amico
CONTEXT: Whether hypofractionated radiation therapy (RT) compared with conventionally fractionated RT provides comparable or possibly improved cancer control without increased toxicity in localized prostate cancer (PC) remains unknown. OBJECTIVE: Realizing from the CHHiP trial that outcomes are highly sensitive to the dose fractionation schedule and number of treatments, we conducted a systematic review and meta-analysis selecting only the randomized noninferiority trials, because the randomized arms closely approximated one another in terms of the dose fractionation schedule, and compared cancer control and toxicity of hypofractionated RT with conventionally fractionated RT for localized PC...
November 4, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29220295/once-a-week-versus-once-every-3-weeks-cisplatin-chemoradiation-for-locally-advanced-head-and-neck-cancer-a-phase-iii-randomized-noninferiority-trial
#3
Vanita Noronha, Amit Joshi, Vijay Maruti Patil, Jaiprakash Agarwal, Sarbani Ghosh-Laskar, Ashwini Budrukkar, Vedang Murthy, Tejpal Gupta, Anil K D'Cruz, Shripad Banavali, Prathamesh S Pai, Pankaj Chaturvedi, Devendra Chaukar, Nikhil Pande, Arun Chandrasekharan, Vikas Talreja, Dilip Harindran Vallathol, Vijayalakshmi Mathrudev, Aparna Manjrekar, Kamesh Maske, Arati Sanjay Bhelekar, Kavita Nawale, Sadhana Kannan, Vikram Gota, Atanu Bhattacharjee, Shubhada Kane, Shashikant L Juvekar, Kumar Prabhash
Purpose Chemoradiation with cisplatin 100 mg/m2 given once every 3 weeks is the standard of care in locally advanced head and neck squamous cell cancer (LAHNSCC). Increasingly, low-dose once-a-week cisplatin is substituted because of perceived lower toxicity and convenience. However, there is no level 1 evidence of comparable efficacy to cisplatin once every 3 weeks. Patients and Methods In this phase III randomized trial, we assessed the noninferiority of cisplatin 30 mg/m2 given once a week compared with cisplatin 100 mg/m2 given once every 3 weeks, both administered concurrently with curative intent radiotherapy in patients with LAHNSCC...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29220110/non-responsiveness-and-susceptibility-of-opioids-side-effects-related-to-cancer-patients-clinical-characteristics-a-post-hoc-analysis
#4
Oscar Corli, Anna Roberto, Michael I Bennett, Francesca Galli, Nicole Corsi, Eliana Rulli, Raffaella Antonione
BACKGROUND: Response to opioids is not always positive in cancer patients. A considerable proportion of patients do not respond (non-responders, NRs) or experience severe toxicity. The aim of this analysis was to assess the role of demographic characteristics, pain features, comorbidities and ongoing therapy on the lack of efficacy and on the occurrence of severe adverse drug reactions (ADRs). METHODS: This is a post-hoc analysis of a randomized controlled trial that involved 520 patients and was aimed to evaluate the efficacy and safety of four strong opioids...
December 8, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29209535/do-patients-with-reduced-or-excellent-performance-status-derive-the-same-clinical-benefit-from-novel-systemic-cancer-therapies-a-systematic-review-and-meta-analysis
#5
Sierra Cheng, Mahin Qureshi, Eleanor Pullenayegum, Adam Haynes, Kelvin Kw Chan
Background: Whether patients with excellent and reduced performance status (PS) derive different net clinical benefit from novel anticancer systemic therapies on clinical trials is unclear. Materials and methods: A systematic review was conducted of randomised controlled trials (RCTs) cited for drug approvals between 2006 and August 2015 by the Food and Drug Administration, the European Medicines Agency and Health Canada. Included studies had overall survival (OS) and/or progression-free survival (PFS) primary endpoints...
2017: ESMO Open
https://www.readbyqxmd.com/read/29203174/the-efficacy-and-safety-of-first-line-single-agent-chemotherapy-regimens-in-low-risk-gestational-trophoblastic-neoplasia-a-network-meta-analysis
#6
Jun Li, Shufen Li, Hinlin Yu, Jieyu Wang, Congjian Xu, Xin Lu
OBJECTIVE: There is no consensus regarding what should be the optimal single-agent regimen in low-risk gestational trophoblastic neoplasia(LRGTN). we performed this network meta-analysis(NMA) and our aim is to synthesize all efficacy evidence, enabling a comparison of all single-agent methotrexate(MTX)-based or actinomycin-d(Act-D)-based regimens in LRGTN. METHODS: We performed a literature search of PubMed, Embase, and the Cochrane Library for all relevant articles...
December 1, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29202670/cardiovascular-safety-of-non-steroidal-anti-inflammatory-drugs-revisited
#7
Chris Walker, Luigi M Biasucci
Non-steroidal anti-inflammatory drugs (NSAIDs) have been widely used to treat inflammatory pain for decades. More recently, newer NSAIDs were developed to target the inducible isoform of cyclooxygenase (COX), COX-2, with the aim of reducing gastrointestinal toxicity. While the COX-2 selective inhibitors were effective in reducing pain and gastrointestinal harm, they soon were associated with an increased risk of adverse cardiovascular events. Initially, the view emerged that selective inhibition of COX-2, and sparing of COX-1, was responsible for the increased cardiovascular harm observed...
December 5, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/29199672/a-meta-analysis-evaluation-of-safety-and-efficacy-of-the-epidermal-growth-factor-receptor-tyrosine-kinase-inhibitor-monotherapy-versus-platinum-based-doublets-chemotherapy-in-east-asia
#8
X F Zhang, L V De-Sheng, M Li, G E Sun, C H Liu
OBJECTIVE: Several clinical trials have shown that advanced nonsmall cell lung cancer (NSCLC) patients can benefit from treatment with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) monotherapy than receiving platinum-based doublets chemotherapy in the first-line treatment of advanced NSCLC; the objective of this study was to evaluate whether patients could be treated with EGFR-TKI for advanced NSCLC in the first-line setting. PATIENTS AND METHODS: A literature search was conducted on the Cochrane Controlled Trials Register Databases, MEDLINE, EMBASE, Web of Science databases, and Chinese Biomedical Literature Database without exclusion of material published in any language...
January 2017: Indian Journal of Cancer
https://www.readbyqxmd.com/read/29198731/discontinuing-a-non-steroidal-anti-inflammatory-drug-nsaid-in-patients-with-knee-osteoarthritis-design-and-protocol-of-a-placebo-controlled-noninferiority-randomized-withdrawal-trial
#9
Joseph L Goulet, Eugenia Buta, Matthew Brennan, Alicia Heapy, Liana Fraenkel
BACKGROUND: Knee osteoarthritis (OA) is the most common cause of knee pain in older adults. Despite the limited data supporting their use, non-steroidal anti-inflammatory drugs (NSAID) are among the most commonly prescribed medications for knee OA. The use of NSAIDs for knee pain warrants careful examination because of toxicity associated with this class of medications. METHODS: We describe the design of a placebo-controlled, noninferiority, randomized withdrawal trial to examine discontinuation of an NSAID in patients with painful knee OA...
November 30, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29184783/contemporary-role-of-radiotherapy-in-the-management-of-penile-cancer
#10
REVIEW
Martin Arthur Korzeniowski, Juanita Mary Crook
Penile cancer is a rare clinical entity that contributes to significant patient morbidity and mortality. Human papilloma virus (HPV) plays an important role in the carcinogenesis of penile squamous cell carcinoma (SCC), is associated with improved clinical outcomes, and is predictive for response to treatment with chemotherapy and radiotherapy. Historically, treatment consisted of radical surgery with partial or total penectomy. While effective for local control, surgical resection can impart significant physical, psychological and sexual dysfunction for afflicted men...
October 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29182797/palliative-chemotherapy-and-targeted-therapies-for-esophageal-and-gastroesophageal-junction-cancer
#11
REVIEW
Vincent T Janmaat, Ewout W Steyerberg, Ate van der Gaast, Ron Hj Mathijssen, Marco J Bruno, Maikel P Peppelenbosch, Ernst J Kuipers, Manon Cw Spaander
BACKGROUND: Almost half of people with esophageal or gastroesophageal junction cancer have metastatic disease at the time of diagnosis. Chemotherapy and targeted therapies are increasingly used with a palliative intent to control tumor growth, improve quality of life, and prolong survival. To date, and with the exception of ramucirumab, evidence for the efficacy of palliative treatments for esophageal and gastroesophageal cancer is lacking. OBJECTIVES: To assess the effects of cytostatic or targeted therapy for treating esophageal or gastroesophageal junction cancer with palliative intent...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29182706/clinical-effects-of-tramiprosate-in-apoe4-4-homozygous-patients-with-mild-alzheimer-s-disease-suggest-disease-modification-potential
#12
S Abushakra, A Porsteinsson, P Scheltens, C Sadowsky, B Vellas, J Cummings, S Gauthier, J A Hey, A Power, P Wang, L Shen, M Tolar
BACKGROUND: Alzheimer's Disease (AD) patients homozygous for the APOE4 allele (APOE4/4) have a distinct clinical and biological phenotype with high levels of beta amyloid (Aβ) pathology and toxic Aβ oligomers. Tramiprosate, an oral agent that inhibits Aβ monomer aggregation into toxic oligomers, was evaluated in two Phase 3 Mild to Moderate AD studies which did not show efficacy in the overall population. Re-analyses of these trials showed the most consistent clinical benefits in APOE4/4 patients...
2017: Journal of Prevention of Alzheimer's Disease
https://www.readbyqxmd.com/read/29181651/risk-of-fatigue-in-cancer-patients-receiving-anti-egfr-monoclonal-antibodies-results-from-a-systematic-review-and-meta-analysis-of-randomized-controlled-trial
#13
Jianhong Zhu, Wenxia Zhao, Dan Liang, Guocheng Li, Kaifeng Qiu, Junyan Wu, Jianfang Li
BACKGROUND: To evaluate the association between fatigue and anti-epidermal growth factor receptor monoclonal antibodies (anti-EGFR MAbs), we conducted the first meta-analysis to access the incidence and risk of fatigue associated with anti-EGFR MAbs. METHODS: Electronic databases were searched for randomized controlled trials (RCTs) published up to February 2017. Eligible studies were selected according to PRISMA statement. Incidence rates, risk ratio (RRs), and 95% confidence intervals (CIs) were calculated using fixed-effects or random-effects models...
November 27, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29178983/hypofractionated-radiotherapy-for-prostate-cancer-in-the-postoperative-setting-what-is-the-evidence-so-far
#14
REVIEW
Cristina Picardi, Ioan Perret, Raymond Miralbell, Thomas Zilli
Postoperative external beam radiation therapy (EBRT) is a validated treatment option in the adjuvant setting for prostate cancer patients with aggressive pathological features following radical prostatectomy (RP) or as salvage modality in patients with biochemical recurrence after RP. Contemporary randomized phase III trials have provided evidence for using hypofractionation in the definitive treatment setting as an alternative to standard fractionated regimens. Biomathematical modeling for prostate cancer fractionated EBRT associated with widely available refined treatment delivery techniques such as volumetric modulated-arc therapy with image-guided RT may improve the therapeutic ratio...
November 14, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29178937/an-optimized-background-regimen-design-to-evaluate-the-contribution-of-levofloxacin-to-multidrug-resistant-tuberculosis-treatment-regimens-study-protocol-for-a-randomized-controlled-trial
#15
Tara C Bouton, Patrick P J Phillips, Carole D Mitnick, Charles A Peloquin, Kathleen Eisenach, Ramonde F Patientia, Leonid Lecca, Eduardo Gotuzzo, Neel R Gandhi, Donna Butler, Andreas H Diacon, Bruno Martel, Juan Santillan, Kathleen Robergeau Hunt, Dante Vargas, Florian von Groote-Bidlingmaier, Carlos Seas, Nancy Dianis, Antonio Moreno-Martinez, C Robert Horsburgh
BACKGROUND: Current guidelines for treatment of multidrug-resistant tuberculosis (MDR-TB) are largely based on expert opinion and observational data. Fluoroquinolones remain an essential part of MDR-TB treatment, but the optimal dose of fluoroquinolones as part of the regimen has not been defined. METHODS/DESIGN: We designed a randomized, blinded, phase II trial in MDR-TB patients comparing across levofloxacin doses of 11, 14, 17 and 20 mg/kg/day, all within an optimized background regimen...
November 25, 2017: Trials
https://www.readbyqxmd.com/read/29175466/photodynamic-therapy-for-treatment-of-oral-mucositis-pilot-study-with-pediatric-patients-undergoing-chemotherapy
#16
Vânia Cavalcanti Ribeiro da Silva, Fabiana Moura da Motta Silveira, Gabriela Souza Lima, Mônica Moreira Dias da Cruz, Arnaldo de França Caldas Júnior, Gustavo Pina Godoy
BACKGROUND: Oral mucositis has become a major factor dose-limiting toxicity of antineoplastic treatment. AIM: The aim of the present study was to evaluate the effect of photodynamic therapy (PDT) and low level laser therapy (LLLT) on the treatment of chemotherapy-induced mucositis in pediatric patients. METHODS: An open, controlled, and blind, randomized clinical trial was conducted with 29 patients, from 10 months to 18 years old, who were divided into two groups...
November 22, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/29174940/absorbable-hydrogel-spacer-use-in-prostate-radiotherapy-a-comprehensive-review-of-phase-3-clinical-trial-published-data
#17
Lawrence Karsh, Eric Gross, Christopher M Pieczonka, Philip J Aliotta, Christopher J Skomra, Lee E Ponsky, Peter T Nieh, Misop Han, Daniel A Hamstra, Neal D Shore
OBJECTIVES: To provide an update on SpaceOAR® System, a FDA approved hydrogel indicated to create distance between the prostate and rectum which has been studied in phase 2 and 3 clinical trials. Here we review and summarize these clinical results including: the safety of prostate-rectum spacer application technique, the implant quality and resulting rectal dose reduction, acute and long term rectal, urinary and sexual toxicity as well as patient reported outcomes. METHODS: A prospective, randomized patient-blinded clinical study was performed comparing image-guided intensity modulated prostate radiotherapy (IG-IMRT) (79...
November 23, 2017: Urology
https://www.readbyqxmd.com/read/29174481/a-comparison-of-regorafenib-and-tas-102-for-metastatic-colorectal-cancer-a-systematic-review-and-network-meta-analysis
#18
Ana B K Abrahao, Yoo-Joung Ko, Scott Berry, Kelvin K W Chan
BACKGROUND: Regorafenib and TAS-102 have shown to be superior to placebo in refractory metastatic colorectal cancer. However, no studies have directly compared both drugs. Giving the lack of standard options in this scenario, a systematic review to compare the efficacy and safety of regorafenib and TAS-102 was performed. MATERIALS AND METHODS: A systematic review using the PubMed, Medline, Embase, Scopus, and Cochrane databases to identify published and unpublished studies up to November 2015 for randomized controlled trials for patients with metastatic colorectal cancer, involving regorafenib or TAS-102, was performed...
November 21, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29167951/radioembolization-versus-bland-embolization-for-hepatic-metastases-from-small-intestinal-neuroendocrine-tumors-short-term-results-of-a-randomized-clinical-trial
#19
Anna-Karin Elf, Mats Andersson, Olof Henrikson, Oscar Jalnefjord, Maria Ljungberg, Johanna Svensson, Bo Wängberg, Viktor Johanson
BACKGROUND: Radioembolization (RE) with intra-arterial administration of (90)Y microspheres is a promising technique for the treatment of liver metastases from small intestinal neuroendocrine tumors (SI-NET) not amenable to surgery or local ablation. However, studies comparing RE to other loco-regional therapies are lacking. The aim of this randomized study was to compare the therapeutic response and safety after RE and bland hepatic arterial embolization (HAE), and to investigate early therapy-induced changes with diffusion-weighted MRI (DWI-MRI)...
November 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29163832/neoadjuvant-chemotherapy-followed-by-surgery-versus-upfront-surgery-in-non-metastatic-non-small-cell-lung-cancer-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#20
Xiao-Nan Zhang, Lei Huang
Background: The favorable effect of postoperative chemotherapy on long-term survival has been well acknowledged in non-small cell lung cancer (NSCLC), while the role of neoadjuvant chemotherapy (NAC) remains obscure. This meta-analysis enrolling high-quality randomized controlled trials (RCTs) aimed at comparing NAC followed by surgery with upfront surgery (US) in efficacy and safety among non-metastatic NSCLC patients. Materials and Methods: Relevant literatures were searched systematically from MEDLINE, EMBASE, and the Cochrane Library...
October 27, 2017: Oncotarget
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