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Isolated limb infusion

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https://www.readbyqxmd.com/read/29866227/acute-massive-gastrointestinal-bleeding-in-the-elderly
#1
Jian-Yuan Gao, Jin-Feng Chen, Hui Su, Hai-Ying Fang, Li-Ping Wu, Ya-Jun Han, Xiao-Ming Wang
An 82-year patient presented with nausea, coffee-ground emesis, melena and hematochezia on July 10, 2011. The patient received blood transfusion on July 11, and continued to bleed from July 12 to 17. The patient underwent upper gastrointestinal endoscopy on July 16. There were no abnormalities in the esophagus, stomach and duodenum. Then the patient presented with shortness of breath, extreme fear, fatigue, hypotension, sweating, and cold limbs. Dopamine, as well as pressurised infusion of packed red blood cells and fresh frozen plasma were given to the patient to maintain blood pressure...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29736626/regional-therapies-for-locoregionally-advanced-and-unresectable-melanoma
#2
Evan S Weitman, Jonathan S Zager
Locoregionally advanced and unresectable disease can be seen in up to 10% of melanoma patients. Treatment options for these patients have been evolving most notably over the past few decades and have demonstrated efficacy through multiple intra-arterial as well as intralesional therapies. Isolated limb perfusions and isolated limb infusions have been utilized to treat locoregionally advanced melanoma of the extremity with overall response rates up to 90% in some reports. Intralesional therapies, for in transit metastatic melanoma, such as Bacille Calmette-Guerin, talimogene laherparepvec, and PV-10 (Rose Bengal) have all demonstrated efficacy in the treatment of unresectable cutaneous melanoma...
May 8, 2018: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/29389234/duration-of-anti-programmed-death-1-therapy-in-advanced-melanoma-how-much-of-a-good-thing-is-enough
#3
Nikhil I Khushalani
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
February 1, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29339377/robust-antitumor-responses-result-from-local-chemotherapy-and-ctla-4-blockade
#4
Charlotte E Ariyan, Mary Sue Brady, Robert H Siegelbaum, Jian Hu, Danielle M Bello, Jamie Rand, Charles Fisher, Robert A Lefkowitz, Kathleen S Panageas, Melissa Pulitzer, Marissa Vignali, Ryan Emerson, Christopher Tipton, Harlan Robins, Taha Merghoub, Jianda Yuan, Achim Jungbluth, Jorge Blando, Padmanee Sharma, Alexander Y Rudensky, Jedd D Wolchok, James P Allison
Clinical responses to immunotherapy have been associated with augmentation of preexisting immune responses, manifested by heightened inflammation in the tumor microenvironment. However, many tumors have a noninflamed microenvironment, and response rates to immunotherapy in melanoma have been <50%. We approached this problem by utilizing immunotherapy (CTLA-4 blockade) combined with chemotherapy to induce local inflammation. In murine models of melanoma and prostate cancer, the combination of chemotherapy and CTLA-4 blockade induced a shift in the cellular composition of the tumor microenvironment, with infiltrating CD8+ and CD4+ T cells increasing the CD8/Foxp3 T-cell ratio...
February 2018: Cancer Immunology Research
https://www.readbyqxmd.com/read/29022281/isolated-limb-perfusion-and-infusion-for-extremity-soft-tissue-sarcoma-a-contemporary-systematic-review-and-meta-analysis
#5
Madalyn G Neuwirth, Yun Song, Andrew J Sinnamon, Douglas L Fraker, Jonathan S Zager, Giorgos C Karakousis
BACKGROUND: Isolated limb perfusion (ILP) and isolated limb infusion (ILI) have been variably used in recent years for the treatment of locally advanced or marginally resectable extremity soft tissue sarcomas (STSs). We performed a systematic review and meta-analysis of contemporary studies to further characterize treatment patterns and outcomes. METHODS: PubMed was queried for articles published in or after the year 2000, in the English language, with > 10 patients, and with adequate outcome data following ILP/ILI...
December 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29019175/isolated-limb-infusion-a-single-center-experience-with-over-200-infusions
#6
Cristina O'Donoghue, Matthew C Perez, John E Mullinax, Danielle Hardman, Sean Sileno, Syeda Mahrukh Hussnain Naqvi, Youngchul Kim, Ricardo J Gonzalez, Jonathan S Zager
BACKGROUND: Isolated limb infusion (ILI) is a minimally invasive technique for delivering regional chemotherapy to an extremity for patients with locally advanced cutaneous malignancies and sarcoma. METHODS: A single-institution, prospectively collected database was analyzed for intention-to-treat with ILI. RESULTS: From 2007 to 2016, 163 patients underwent 205 procedures (201 were successfully completed), and four malignancies were treated: melanoma (72...
December 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28799064/safety-and-efficacy-of-isolated-limb-infusion-chemotherapy-for-advanced-locoregional-melanoma-in-elderly-patients-an-australian-multicenter-study
#7
Hidde M Kroon, Brendon J Coventry, Mitchell H Giles, Michael A Henderson, David Speakman, Mark Wall, Andrew Barbour, Jonathan Serpell, Paul Paddle, Bernard M Smithers, John F Thompson
BACKGROUND: Isolated limb infusion (ILI) offers a minimally invasive treatment option for locally advanced extremity melanoma. OBJECTIVE: The aim of the current study was to evaluate the safety and efficacy of ILI in elderly patients in an Australian multicenter setting. METHODS: The results of 316 first ILI procedures, performed between 1992 and 2008 in five Australian institutions, were identified and analyzed, with the main focus on elderly patients (≥75 years of age)...
October 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28251494/the-role-of-surgery-for-melanoma-in-an-era-of-effective-systemic-therapy
#8
REVIEW
Siavash Raigani, Sonia Cohen, Genevieve M Boland
PURPOSE OF REVIEW: The recent discovery of effective systemic treatments for melanoma has dramatically improved the prognosis for patients with advanced disease. As a result, the multidisciplinary management of melanoma has evolved significantly. In the past decades surgery was reserved for symptomatic palliation in patients with metastatic melanoma. Today surgical treatment of patients responding to systemic therapies has become an integral part of disease control. RECENT FINDINGS: Current efforts are focused on minimizing the morbidity of surgery (laparoscopic inguinal lymph node dissection, selective completion lymphadenectomy) as well as combining surgery with systemic therapy in novel ways (neoadjuvant targeted and/or immunotherapy, isolated limb infusion/perfusion with systemic immunotherapy)...
March 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28214556/isolated-limb-infusion-as-a-limb-salvage-strategy-for-locally-advanced-extremity-sarcoma
#9
John E Mullinax, Hidde M Kroon, John F Thompson, Neel Nath, Paul J Mosca, Jeffrey M Farma, Rajendra Bhati, Danielle Hardmann, Sean Sileno, Cristina O'Donoghue, Matthew Perez, Syeda Mahrukh Hussnain Naqvi, Y Ann Chen, Ricardo J Gonzalez, Jonathan S Zager
BACKGROUND: Treatment-resistant, locally advanced soft tissue sarcomas often require amputation for complete tumor extirpation. Isolated limb infusion (ILI) selectively delivers high-dose chemotherapy to the extremity in an attempt to achieve limb salvage. The aim of this study was to report perioperative and oncologic outcomes after ILI in patients with extremity soft tissue sarcomas. STUDY DESIGN: From 1994 to 2016, 77 patients underwent 84 ILIs at a total of 5 institutions...
April 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27897028/a-single-center-experience-with-isolated-limb-infusion-an-interventional-oncology-opportunity
#10
Adam DeFoe, Andrew Heckman, Dick Slater, Edibaldo Silva-Lopez, Jason Foster, Thom Bowden, Christopher Vargo
OBJECTIVE: This retrospective review details our experience with isolated limb infusion for the treatment of melanoma, squamous cell carcinoma, and sarcoma in-transit metastases performed entirely in the interventional radiology suite. Eleven patients were treated over a 3-year period. Treatment response was assessed clinically and with PET/CT. CONCLUSION: Eight patients had either complete or partial response, giving an overall response rate of 72%. Isolated limb infusion can efficiently be performed entirely in the interventional radiology suite...
March 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27859767/mechanisms-for-the-control-of-local-tissue-blood-flow-during-thermal-interventions-influence-of-temperature-dependent-atp-release-from-human-blood-and-endothelial-cells
#11
Kameljit K Kalsi, Scott T Chiesa, Steven J Trangmar, Leena Ali, Makrand D Lotlikar, José González-Alonso
What is the central question of this study? Skin and muscle blood flow increases with heating and decreases with cooling, but the temperature-sensitive mechanisms underlying these responses are not fully elucidated. What is the main finding and its importance? We found that local tissue hyperaemia was related to elevations in ATP release from erythrocytes. Increasing intravascular ATP augmented skin and tissue perfusion to levels equal or above thermal hyperaemia. ATP release from isolated erythrocytes was altered by heating and cooling...
February 1, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/27680682/preclinical-validation-of-a-single-treatment-infusion-modality-that-can-eradicate-extremity-melanomas
#12
Minhyung Kim, Nickolay Neznanov, Chandler D Wilfong, Daria I Fleyshman, Andrei A Purmal, Gary Haderski, Patricia Stanhope-Baker, Catherine A Burkhart, Katerina V Gurova, Andrei V Gudkov, Joseph J Skitzki
Isolated limb perfusion (ILP) with the chemotherapeutic agent melphalan is an effective treatment option for extremity in-transit melanoma but is toxic and technically challenging to deliver locoregionally. CBL0137 is an experimental clinical drug with broad anticancer activity in animal models, owing to its ability to bind DNA in a nongenotoxic manner and inactivate the FACT chromatin modulator essential for tumor cell viability. Here, we report that CBL0137 delivered by ILP in a murine melanoma model is as efficacious as melphalan, displaying antitumor activity at doses corresponding to only a fraction of the systemic MTD of CBL0137...
November 15, 2016: Cancer Research
https://www.readbyqxmd.com/read/27664339/quiescent-pluripotent-stem-cells-reside-within-murine-peripheral-nerves-that-can-be-stimulated-to-proliferate-by-recombinant-human-bone-morphogenic-protein-2-or-by-nerve-trauma
#13
Michael H Heggeness, Nora Strong, Paul H Wooley, Shang-You Yang
BACKGROUND: The clinical use of recombinant human bone morphogenic protein 2 (rhBMP-2, Infuse) has been associated with nerve-related complications including new-onset sciatica, and retrograde ejaculation. PURPOSE: To better understand the interaction of rhBMP-2 and peripheral nerves with the intent of making procedures safer. STUDY DESIGN/SETTING: Using a mouse model to examine the direct effect of diluted rhBMP-2 (Infuse) on murine sciatic nerves...
February 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27600523/reconstituted-high-density-lipoproteins-promote-wound-repair-and-blood-flow-recovery-in-response-to-ischemia-in-aged-mice
#14
Tania Tsatralis, Anisyah Ridiandries, Stacy Robertson, Laura Z Vanags, Yuen Ting Lam, Joanne T M Tan, Martin K C Ng, Christina A Bursill
BACKGROUND: The average population age is increasing and the incidence of age-related vascular complications is rising in parallel. Impaired wound healing and disordered ischemia-mediated angiogenesis are key contributors to age-impaired vascular complications that can lead to amputation. High-density lipoproteins (HDL) have vasculo-protective properties and augment ischemia-driven angiogenesis in young animals. We aimed to determine the effect of reconstituted HDL (rHDL) on aged mice in a murine wound healing model and the hindlimb ischemia (HLI) model...
September 6, 2016: Lipids in Health and Disease
https://www.readbyqxmd.com/read/27570911/codelivery-of-infusion-decellularized-skeletal-muscle-with-minced-muscle-autografts-improved-recovery-from-volumetric-muscle-loss-injury-in-a-rat-model
#15
Benjamin Kasukonis, John Kim, Lemuel Brown, Jake Jones, Shahryar Ahmadi, Tyrone Washington, Jeffrey Wolchok
Skeletal muscle is capable of robust self-repair following mild trauma, yet in cases of traumatic volumetric muscle loss (VML), where more than 20% of a muscle's mass is lost, this capacity is overwhelmed. Current autogenic whole muscle transfer techniques are imperfect, which has motivated the exploration of implantable scaffolding strategies. In this study, the use of an allogeneic decellularized skeletal muscle (DSM) scaffold with and without the addition of minced muscle (MM) autograft tissue was explored as a repair strategy using a lower-limb VML injury model (n = 8/sample group)...
October 2016: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/27540361/netupitant-a-potent-and-highly-selective-nk1-receptor-antagonist-alleviates-acetic-acid-induced-bladder-overactivity-in-anesthetized-guinea-pigs
#16
Stefano Palea, Véronique Guilloteau, Moéz Rekik, Emanuela Lovati, Marc Guerard, Maria-Alba Guardia, Philippe Lluel, Claudio Pietra, Mitsuharu Yoshiyama
Introduction. Tachykinins potently contract the isolated urinary bladder from a number of animal species and play an important role in the regulation of the micturition reflex. On the guinea-pig isolated urinary bladder we examined the effects of a new potent and selective NK1 receptor antagonist (netupitant) on the contractions induced by a selective NK1 receptor agonist, SP-methylester (SP-OMe). Moreover, the effects of netupitant and another selective NK1 antagonist (L-733,060) were studied in anesthetized guinea-pigs using two experimental models, the isovolumetric bladder contractions and a model of bladder overactivity induced by intravesical administration of acetic acid (AA)...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27237868/intralesional-pv-10-for-in-transit-melanoma-a-single-center-experience
#17
Jocelyn Lippey, Rhiannon Bousounis, Cori Behrenbruch, Bartholomew McKay, John Spillane, Michael A Henderson, David Speakman, David E Gyorki
BACKGROUND AND OBJECTIVES: Patients with in-transit melanoma metastasis have longer median survival than patients with distant metastatic disease. Furthermore, local disease control is an important endpoint for symptom management. The treatment of unresectable loco-regional recurrence or in-transit disease has been historically managed with a combination of treatments including surgery, radiotherapy, isolated limb infusion or perfusion as well as systemic therapies. Intralesional PV-10 has been used at Peter MacCallum Cancer Centre since 2010, and the current report presents a retrospective analysis of patient outcomes, reporting the response rates, durability of responses, and observed toxicities...
September 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/26926481/clinical-response-and-regional-toxicity-following-isolated-limb-infusion-compared-with-isolated-limb-perfusion-for-in-transit-melanoma
#18
Lesly A Dossett, Ilan Ben-Shabat, Roger Olofsson Bagge, Jonathan S Zager
BACKGROUND: Isolated limb perfusion (ILP) and infusion (ILI) are therapeutic modalities for the treatment of in transit melanoma. METHODS: A retrospective review of all patients undergoing first-time ILI or ILP for in-transit melanoma metastases between 2007 and 2015 was performed. Demographic and clinical characteristics included age, sex, nodal status at the time of ILI/ILP (N-stage), and burden of disease (BOD). Regional toxicity was categorized by the Wieberdink classification...
July 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/26797898/use-patterns-and-costs-of-isolated-limb-perfusion-and-infusion-in-the-treatment-of-regional-metastatic-melanoma-a-retrospective-database-analysis
#19
Qiufei Ma, Zhongyun Zhao, Beth L Barber, Mark Shilkrut
INTRODUCTION: Isolated limb perfusion and infusion (ILP/ILI) are therapies for regional metastatic melanoma that allow high doses of anticancer drugs to be delivered directly into the circulation of an affected limb, thereby minimizing systemic drug toxicity. This procedure can lead to high response rates and is recommended in patients with Stage III unresectable metastatic melanoma. However, limited information is available on patterns of use and costs. This study examined patterns of ILP/ILI use and associated costs in patients with melanoma in the United States (US)...
February 2016: Advances in Therapy
https://www.readbyqxmd.com/read/26768512/neoadjuvant-use-of-ipilimumab-in-locally-advanced-melanoma
#20
Lynn J Howie, Douglas S Tyler, April K S Salama
Recent advances in immune modulating therapies show great promise for patients with advanced melanoma, however optimal strategies for achieving long-term disease control in locally advanced melanoma are unclear. We present two cases of neoadjuvant ipilimumab, one case in combination with isolated limb infusion (ILI) followed by surgical resection and one followed by surgery alone. Both patients have had durable responses. These cases highlight the ongoing need for prospective trials in the neoadjuvant setting...
December 2015: Journal of Surgical Oncology
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