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febrile neutropenia in cancer

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https://www.readbyqxmd.com/read/29778788/maintaining-dose-intensity-of-adjuvant-chemotherapy-in-older-patients-with-breast-cancer
#1
Rahul Ladwa, Timothy Kalas, Shivanshan Pathmanathan, Natasha Woodward, David Wyld, Jasotha Sanmugarajah
INTRODUCTION: Maintaining the relative dose intensity (RDI) of adjuvant chemotherapy at ≥ 85% has been associated with improved treatment outcomes in early-stage breast cancer (ESBC). Increasing evidence has suggested that patients aged ≥ 65 years can maintain the optimal RDI for standard chemotherapy regimens. The present study investigated the RDI of newer adjuvant chemotherapy regimens in this demographic. PATIENTS AND METHODS: We retrospectively analyzed the data from 281 patients aged ≥ 65 years with a diagnosis of ESBC who had received adjuvant chemotherapy across 3 sites in Queensland, Australia from 2010 to 2015...
April 28, 2018: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29778738/risk-adapted-therapy-for-young-children-with-medulloblastoma-sjyc07-therapeutic-and-molecular-outcomes-from-a-multicentre-phase-2-trial
#2
Giles W Robinson, Vasilisa A Rudneva, Ivo Buchhalter, Catherine A Billups, Sebastian M Waszak, Kyle S Smith, Daniel C Bowers, Anne Bendel, Paul G Fisher, Sonia Partap, John R Crawford, Tim Hassall, Daniel J Indelicato, Frederick Boop, Paul Klimo, Noah D Sabin, Zoltan Patay, Thomas E Merchant, Clinton F Stewart, Brent A Orr, Jan O Korbel, David T W Jones, Tanvi Sharma, Peter Lichter, Marcel Kool, Andrey Korshunov, Stefan M Pfister, Richard J Gilbertson, Robert P Sanders, Arzu Onar-Thomas, David W Ellison, Amar Gajjar, Paul A Northcott
BACKGROUND: Young children with medulloblastoma have a poor overall survival compared with older children, due to use of radiation-sparing therapy in young children. Radiotherapy is omitted or reduced in these young patients to spare them from debilitating long-term side-effects. We aimed to estimate event-free survival and define the molecular characteristics associated with progression-free survival in young patients with medulloblastoma using a risk-stratified treatment strategy designed to defer, reduce, or delay radiation exposure...
May 16, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29777383/predictive-value-of-pct-and-il-6-for-bacterial-infection-in-children-with-cancer-and-febrile-neutropenia
#3
Hilde T van der Galiën, Erik A H Loeffen, Karin G E Miedema, Wim J E Tissing
PURPOSE: Only a third of children with cancer and febrile neutropenia (FN) have a proven bacterial infection; nevertheless, most children are hospitalized and treated with intravenous antibiotics. Several biomarkers have been proposed as predictive markers for bacterial infection in this population. We aimed to evaluate the role of interleukin-6 (IL-6) and procalcitonin (PCT) in diagnosing bacterial infection in children with cancer and FN. METHODS: The study population was derived from a prospective database (2006-2013, IL-8 study) comprising children with cancer who presented with FN...
May 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29768957/comparison-of-the-incidence-of-febrile-neutropenia-in-obese-and-normal-weight-breast-cancer-patients-receiving-myelosuppressive-chemotherapy-and-prophylactic-pegfilgrastim
#4
Jennifer M Collins, Gini F Fleming, Trevor N Christ
Purpose Common breast cancer chemotherapy regimens are associated with a risk of febrile neutropenia, so prophylactic colony-stimulating factors are incorporated for high-risk patients. Filgrastim utilizes weight-based dosing; however, its sustained-release formulation utilizes fixed dosing. The purpose of this study is to determine whether obese breast cancer patients who receive pegfilgrastim are at increased risk of developing febrile neutropenia. Methods This study is a single-center, retrospective chart review...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29768710/improving-the-safety-of-high-dose-methotrexate-for-children-with-hematologic-cancers-in-settings-without-access-to-mtx-levels-using-extended-hydration-and-additional-leucovorin
#5
Kalthi Vaishnavi, Deepak Bansal, Amita Trehan, Richa Jain, Savita Verma Attri
BACKGROUND: A lack of access to methotrexate levels is common in low- and middle-income countries (LMIC), relevant for 80% of children with cancer worldwide. We evaluated whether high-dose methotrexate (HD-MTX) can be administered safely with extended hydration and leucovorin rescue, with monitoring of serum creatinine and urine pH. METHODS: The prospective study was conducted at a single centre in Chandigarh, India in 2015. Patients with B-cell acute lymphoblastic leukemia (ALL) or with T-cell ALL or non-Hodgkin lymphoma (T-NHL) were administered 3 and 5 gm/m2 of MTX (24 hr infusion), respectively...
May 16, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29768470/integrative-omics-to-detect-bacteremia-in-patients-with-febrile-neutropenia
#6
Rachel S Kelly, Jessica Lasky-Su, Sai-Ching J Yeung, Richard M Stone, Jeffrey M Caterino, Sean C Hagan, Gary H Lyman, Lindsey R Baden, Brett E Glotzbecker, Christopher J Coyne, Christopher W Baugh, Daniel J Pallin
BACKGROUND: Cancer chemotherapy-associated febrile neutropenia (FN) is a common condition that is deadly when bacteremia is present. Detection of bacteremia depends on culture, which takes days, and no accurate predictive tools applicable to the initial evaluation are available. We utilized metabolomics and transcriptomics to develop multivariable predictors of bacteremia among FN patients. METHODS: We classified emergency department patients with FN and no apparent infection at presentation as bacteremic (cases) or not (controls), according to blood culture results...
2018: PloS One
https://www.readbyqxmd.com/read/29754293/chemotherapy-induced-neutropenia-as-a-prognostic-and-predictive-marker-of-outcomes-in-solid-tumor-patients
#7
REVIEW
Pashtoon Murtaza Kasi, Axel Grothey
Chemotherapy-induced neutropenia (CIN) is one of the most common side effects seen in cancer patients. As an adverse event, it is deemed undesirable since it often constitutes a dose-limiting toxicity for cytotoxic agents leading to treatment delays and/or dose reductions. It is also associated with a financial cost component from diagnostic work-up and treatment of patients with chemotherapy-induced febrile neutropenia (CIFN). Neutropenia is commonly accompanied by a decrease in other hematopoietic lineages (anemia and/or thrombocytopenia)...
May 12, 2018: Drugs
https://www.readbyqxmd.com/read/29748897/myeloid-derived-suppressor-cells-mdscs-in-patients-with-solid-tumors-considerations-for-granulocyte-colony-stimulating-factor-treatment
#8
REVIEW
Katerina Pilatova, Beatrix Bencsikova, Regina Demlova, Dalibor Valik, Lenka Zdrazilova-Dubska
Myeloid-derived suppressor cells (MDSCs) have been shown to contribute to tumor escape from host immune surveillance and to cancer progression by production of tumor-promoting soluble factors. Granulocyte colony-stimulating factor (G-CSF) is a principle cytokine controlling granulocyte number. Recombinant human G-CSF (rhG-CSF) has become the main therapeutic agent for the treatment of neutropenia and prophylaxis of febrile neutropenia in cancer patients. However, we show here that rhG-CSF triggers accumulation of granulocytic and monocytic subsets...
May 10, 2018: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/29744672/efficacy-and-safety-of-neoadjuvant-treatment-with-bevacizumab-liposomal-doxorubicin-cyclophosphamide-and-paclitaxel-combination-in-locally-regionally-advanced-her2-negative-grade-iii-at-premenopausal-status-breast-cancer-a-phase-ii-study
#9
Ekaterini C Tampaki, Athanasios Tampakis, Constantinos E Alifieris, Dimitrios Krikelis, Anastasia Pazaiti, Michalis Kontos, Dimitrios T Trafalis
BACKGROUND: In the era of personalized therapy, targeted treatment in specific patient populations is mandated. OBJECTIVE: We evaluated the efficacy and safety of neoadjuvant treatment on locally advanced breast cancer (LABC) with a monoclonal agent against vascular endothelial growth factor (VEGF), bevacizumab plus chemotherapy combination of liposomal doxorubicin, cyclophosphamide and paclitaxel (PLAC-B). METHODS: Patients enrolled were at premenopausal status and characterized by human epidermal growth factor receptor 2 (HER2)-negative, hormone-receptor positive (estrogen receptor/progesterone receptor-positive [ER/PR+]) or triple-negative (TNBC), LABC (T > 3 cm), with high-grade ductal carcinoma...
May 9, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29739790/phase-ib-ii-study-of-second-line-therapy-with-panitumumab-irinotecan-and-everolimus-pie-in-kras-wild-type-metastatic-colorectal-cancer
#10
Amanda Townsend, Niall C Tebbutt, Christos S Karapetis, Pamela Cooper, Nimit Singhal, Sue J Yeend, Louise Pirc, Rohit Joshi, Jennifer Elizabeth Hardingham, Timothy Price
PURPOSE: Inhibition of mTOR in addition to EGFR may overcome resistance to EGFR inhibitors in metastatic colorectal cancer (mCRC). This phase Ib/II study evaluated the safety and efficacy of the combination of irinotecan, panitumumab and everolimus. EXPERIMENTAL DESIGN: Patients with KRAS exon 2 WT mCRC following failure of fluoropyrimidine based therapy received IV irinotecan and panitumumab every 2 weeks, and everolimus orally throughout a 14 day cycle. The primary endpoint of the phase II study was response rate (RR)...
May 8, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29737253/febrile-neutropenia-in-children-with-cancer-approach-to-diagnosis-and-treatment
#11
Rejin Kebudi, Hande Kizilocak
Febrile neutropenia is one of the major acute side effects of intensive treatment in pediatric cancer, necessitating prompt initiation of empirical broad-spectrum antibiotics. Patients may be classified as low or high risk according some risk factors (duration of neutropenia, depth of neutropenia, type of cancer, state of disease, bone marrow involvement, type of treatment, additional health problems). Initial evaluation of the febrile neutropenic child should include the history of the child, a detailed physical examination, blood culture (peripheral and catheter), urinalysis and culture, cultures of lesions...
May 8, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29736867/development-of-a-simplified-multivariable-model-to-predict-neutropenic-complications-in-cancer-patients-undergoing-chemotherapy
#12
Abolfazl Razzaghdoust, Bahram Mofid, Maryam Moghadam
PURPOSE: Neutropenic complications remain the major dose-limiting toxicities of cancer chemotherapy. The aim of this study was to develop and internally validate a comprehensive and easily measurable scoring system for prediction of severe or febrile neutropenia in the first chemotherapy cycle of patients with solid tumors or lymphoma. METHODS: This prospective cohort study included consecutive patients at a tertiary referral hospital. Many clinical and laboratory-independent variables were measured at baseline...
May 7, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29732352/pegfilgrastim-for-primary-prophylaxis-of-febrile-neutropenia-in-breast-cancer-patients-undergoing-tac-chemotherapy
#13
Jihyoun Lee, Jong Eun Lee, Zisun Kim, Sun Wook Han, Sung Mo Hur, Sung Yong Kim, Min Hyuk Lee, Cheol Wan Lim
Purpose: Primary prophylaxis with granulocyte colony-stimulating factor can effectively prevent febrile neutropenia (FN) during breast cancer treatment. The aims of this study were to evaluate the incidence of FN and the ANC profile in patients undergoing chemotherapy and pegfilgrastim primary prophylaxis. Methods: Patients receiving 6 cycles of adjuvant docetaxel, doxorubicin, and cyclophosphamide (TAC) chemotherapy were included in this study. Pegfilgrastim was administered with analgesics 24 hours after treatment...
May 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29721850/exposure-response-relationship-for-ramucirumab-from-the-randomized-double-blind-phase-3-revel-trial-docetaxel-versus-docetaxel-plus-ramucirumab-in-second-line-treatment-of-metastatic-non-small-cell-lung-cancer
#14
Egbert F Smit, Edward B Garon, Martin Reck, Federico Cappuzzo, Paolo Bidoli, Roger B Cohen, Ling Gao, Lisa M O'Brien, Pablo Lee, Annamaria Zimmermann, David R Ferry, Allen S Melemed, Maurice Pérol
PURPOSE: Ramucirumab plus docetaxel improved survival in REVEL, a randomized phase 3 trial for patients with Stage IV non-small cell lung cancer after standard platinum-based chemotherapy. This exploratory analysis evaluated the exposure-response relationship of ramucirumab from REVEL. METHODS: Patients received ramucirumab (10 mg/kg) or placebo plus docetaxel (75 mg/m2 ) every 3 weeks. Pharmacokinetic samples were collected. A population pharmacokinetic analysis predicted ramucirumab minimum concentration after first-dose administration (Cmin,1 ) and average concentration at steady state (Cave,ss )...
May 2, 2018: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/29721163/a-phase-ii-trial-of-1st-line-modified-folfoxiri-plus-bevacizumab-treatment-for-metastatic-colorectal-cancer-harboring-ras-mutation-jaccro-cc-11
#15
Hironaga Satake, Yu Sunakawa, Yuji Miyamoto, Masato Nakamura, Hiroshi Nakayama, Manabu Shiozawa, Akitaka Makiyama, Kazuma Kobayashi, Yutaro Kubota, Misuzu Mori, Masahito Kotaka, Akinori Takagane, Masahiro Gotoh, Masahiro Takeuchi, Masashi Fujii, Wararu Ichikawa, Takashi Sekikawa
FOLFOXIRI plus bevacizumab is considered a standard initial therapy for metastatic colorectal cancer (mCRC). However, few prospective trials have evaluated triplet therapy plus bevacizumab in patients with RAS mutant mCRC. Patients with an age of 20 to 75 years, and unresectable, measurable tumors harboring RAS mutation were given first-line treatment with bevacizumab (5 mg/kg on day 1) plus modified-FOLFOXIRI (irinotecan 150 mg/m2 , oxaliplatin 85 mg/m2 , levofolinate 200 mg/m2 , and fluorouracil 2400 mg/m2 as a 46-h continuous infusion on day 1, repeated every 2 weeks)...
April 10, 2018: Oncotarget
https://www.readbyqxmd.com/read/29706375/balixafortide-plus-eribulin-in-her2-negative-metastatic-breast-cancer-a-phase-1-single-arm-dose-escalation-trial
#16
Sonia Pernas, Miguel Martin, Peter A Kaufman, Marta Gil-Martin, Patricia Gomez Pardo, Sara Lopez-Tarruella, Luis Manso, Eva Ciruelos, Jose Alejandro Perez-Fidalgo, Cristina Hernando, Foluso O Ademuyiwa, Katherine Weilbaecher, Ingrid Mayer, Timothy J Pluard, Maria Martinez Garcia, Linda Vahdat, Jose Perez-Garcia, Achim Wach, Debra Barker, Samson Fung, Barbara Romagnoli, Javier Cortes
BACKGROUND: The C-X-C chemokine receptor type 4 (CXCR4)-stromal cell-derived factor-1α (SDF-1α) axis regulates function and trafficking of immune cells and the tumour microenvironment. CXCR4 antagonists have been shown to enhance the activity of different anticancer treatments in preclinical models. We assessed the safety, tolerability, pharmacokinetics, and preliminary phase 1 activity of the CXCR4 antagonist, balixafortide, in combination with eribulin chemotherapy in patients with heavily pretreated, relapsed metastatic breast cancer...
April 26, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29687743/clinical-outcomes-of-treatment-with-filgrastim-versus-a-filgrastim-biosimilar-and-febrile-neutropenia-associated-costs-among-patients-with-nonmyeloid-cancer-undergoing-chemotherapy
#17
Lee S Schwartzberg, Lincy S Lal, Sanjeev Balu, Kim Campbell, Lee Brekke, Andrew DeLeon, Caitlin Elliott, Stephanie Korrer
BACKGROUND: Granulocyte colony-stimulating factors such as filgrastim are used to decrease the incidence of febrile neutropenia (FN) among patients with nonmyeloid cancers undergoing chemotherapy treatment. Although the biosimilar filgrastim-sndz has been approved in the United States since 2015, limited real-world comparisons of filgrastim-sndz versus reference filgrastim (filgrastim-ref) have been conducted. OBJECTIVE: To compare FN incidence and assess overall FN-related health care resource utilization and medical costs among U...
April 24, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29685343/weekly-versus-3-weekly-cabazitaxel-for-the-treatment-of-castration-resistant-prostate-cancer-a-randomised-phase-ii-trial-concab
#18
Jeffrey Yachnin, Bjørnar Gilje, Kristian Thon, Hemming Johansson, Yvonne Brandberg, Theocharis Panaretakis, Anders Ullén
AIM: Patients treated with cabazitaxel for metastatic castration-resistant prostate cancer (mCRPC) may experience dose delays and reductions or terminate treatment because of toxicity. A lower and more frequent dose of cabazitaxel could improve dose intensity. PATIENTS AND METHODS: This prospective, multi-center, phase II study randomly assigned 101 patients to Arm A, cabazitaxel Q3W, 25 mg/m2 or Arm B, Q1W, 10 mg/m2 5 of 6 weeks. The primary end-point was dose intensity, and we hypothesised that the experimental arm (Arm B) would result in a 20% absolute increase in the relative cumulative dose by week 18...
April 20, 2018: European Journal of Cancer
https://www.readbyqxmd.com/read/29683973/nationwide-multicenter-observational-study-of-folfirinox-chemotherapy-in-399-patients-with-unresectable-or-recurrent-pancreatic-cancer-in-japan
#19
Akiko Todaka, Nobumasa Mizuno, Masato Ozaka, Hideki Ueno, Satoshi Kobayashi, Kazuhiro Uesugi, Noritoshi Kobayashi, Hideyuki Hayashi, Kentaro Sudo, Naohiro Okano, Yosuke Horita, Keiko Kamei, Seigo Yukisawa, Shoji Nakamori, Yutaka Yachi, Toshiyuki Henmi, Marina Kobayashi, Narikazu Boku, Keita Mori, Akira Fukutomi
OBJECTIVES: FOLFIRINOX (oxaliplatin, irinotecan, 5-fluorouracil, and leucovorin) is the standard therapy worldwide for unresectable pancreatic cancer; however, clinical data for Japanese patients are limited. Therefore, the observational study of FOLFIRINOX for patients with pancreatic cancer was conducted. METHODS: The study included 399 patients with unresectable or recurrent pancreatic cancer, from 27 institutions in Japan, treated with FOLFIRINOX and surveyed until December 2015...
May 2018: Pancreas
https://www.readbyqxmd.com/read/29675545/a-novel-approach-to-improving-ambulatory-outpatient-management-of-low-risk-febrile-neutropenia-an-enhanced-supportive-care-esc-clinic
#20
Tim Cooksley, Geraldine Campbell, Tamer Al-Sayed, Lisa LaMola, Richard Berman
PURPOSE: Outpatient management of low risk febrile neutropenia patients (LRFN) identified by the MASCC score is a safe and effective strategy. Early supportive care has been shown to improve outcomes in patients with care. We developed an innovative ambulatory outpatient "enhanced supportive care" (ESC) clinic combining emergency oncology and supportive care through which we incorporated the management of patients with LRFN. METHODS: An ESC clinic was started in January 2017 at a tertiary cancer hospital in the North West of England...
April 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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