systemic therapy (Total 571178 Papers Found)

BACKGROUND The National Cancer Institute Black/White Cancer Survival Study began patient accrual in 1985 and was designed to investigate factors that might contribute to the observed racial differences in survival for cancer of the breast, uterine corpus, colon, and bladder. METHODS To determine whether there were racial differences in treatment in a clinically homogeneous set of patients, 305 (25%) of the 1222 women in this study with Stage II node-positive (N+) breast cancer were evaluated. ...
PURPOSE Chimeric antigen receptor-modified T cells (CAR-T) have demonstrated encouraging results in early-phase clinical trials. Successful adaptation of CAR-T technology for CEA-expressing adenocarcinoma liver metastases, a major cause of death in patients with gastrointestinal cancers, has yet to be achieved. We sought to test intrahepatic delivery of anti-CEA CAR-T through percutaneous hepatic artery infusions (HAIs). EXPERIMENTAL DESIGN We conducted a phase I trial to test HAI of CAR-T in ...
Adjuvant radiotherapy after modified radical mastectomy and breast-conserving surgery for early-stage invasive breast cancer substantially reduces the risk of locoregional failure and is evidence-based. Using traditional clinical and pathological factors, patients can be classified into subgroups by the risk of locoregional recurrence. In the high-risk groups the absolute benefit of irradiation is larger. However, the patients are over-treated in every subgroup. Substantial proportion of the pat ...
Kaposi's sarcoma is the most common tumor found in patients with the acquired immunodeficiency syndrome. This opportunistic neoplasm has characteristics of a sexually transmitted disease. Growth factors, cytokines, immune suppression, and interaction with infectious organisms all appear to play a role in the pathogenesis of this enigmatic disorder. The manifestations of Kaposi's sarcoma are protean, and lesions may appear at any time in the course of human immunodeficiency virus disease, remain ...
As options for systemic therapy for cancer continue to expand and median survival for many solid tumors lengthens, the divisions between active oncologic and palliative care continue to blur. Despite the well-recognized need to integrate palliative support for those with metastatic cancer, data on best practices facilitating the transition from active oncologic to active palliative care are lacking. Recent evidence outlining evolving issues surrounding this transition in care is reviewed, emphas ...
49 Background: Metastatic breast cancer to the contralateral axilla is defined as stage IV disease. We postulate that metastatic disease to the contralateral axilla is secondary to extension of aggressive, local regional disease rather than distant metastatic disease and may have a better outcome. METHODS An IRB-approved retrospective review of breast cancer cases presenting to a single institution between January 2005 and December 2011 was performed to identify cases with contralateral axilla ...
Objective The purpose of this guideline is to recommend systemic therapy options for women with recurrent epithelial ovarian cancer, including fallopian tube and primary peritoneal cancers. Methods This document updates the recommendations published in the 2011 Optimal Chemotherapy for Recurrent Ovarian Cancer guideline from Cancer Care Ontario. Draft recommendations were formulated based on evidence obtained through a systematic review of phase ii and iii randomized controlled trials (rcts). ...
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  • Nature Clinical Practice Oncology
  • 2005
Adjuvant systemic therapy is recommended for the prevention of recurrence in most patients with lymph-node-negative breast cancer, but some individuals might not require such aggressive treatment. Wang and colleagues have identified a ‘genetic signature’ which could help to prevent overtreatment by identifying patients at low risk of distant metastases. Using microarray technology, Wang et al. analyzed the expression of 22,000 genes in tumor samples from 115 lymph-node-negative breast cancer ...
The development of CNS metastasis in patients with solid malignancies represents a turning point in the disease process. The prevalence of CNS metastasis from breast cancer may be increasing due to improved systemic therapy for stage IV breast cancer. The standard treatment for multiple brain lesions remains whole-brain radiation for symptom control, with no improvement in survival. The therapy for a single brain metastasis remains either surgery or radiosurgery, with conflicting information as ...
BACKGROUND Epithelial ovarian cancer (OC) remains a significant cause of morbidity and mortality for women worldwide. Patients may experience a multitude of disease- and treatment-related symptoms that can impact quality of life (QOL) and should be measured and reported in clinical trials. This systematic review investigated the adequacy of reporting of QOL in randomized phase III trials in OC in both the first-line and recurrent disease setting. MATERIALS AND METHODS A systematic review of ME ...
We have previously developed a quantitative PCR (QPCR) technique for the detection of cytokeratin 19 (CK19) transcripts in blood and bone marrow and compared this to immunocytochemistry (ICC). Together, both have shown promise for monitoring therapeutic efficacy in patients with metastatic breast cancer. The aim of this study was to determine the feasibility and value of these assays for minimal residual disease (MRD) in monitoring efficacy of adjuvant therapy following surgery for primary breas ...
We recently developed a therapeutic biopolymer composed of an elastin-like polypeptide (ELP) fused to vascular endothelial growth factor (VEGF) and showed long-term renoprotective effects in experimental renovascular disease after a single intra-renal administration. Here, we sought to determine the specificity, safety, efficacy, and mechanisms of renoprotection of ELP-VEGF after systemic therapy in renovascular disease. We tested whether kidney selectivity of the ELP carrier would reduce off-ta ...
In the course of the last decade the therapy of renal cell carcinoma (RCC) stepped into a new era as targeted therapies changed protocols and the prognosis of patients as well. Could this successful start with sunitinib and sorafenib be continued by more potent agents? Because objective response rates (ORR) are still far from ideal (none of them reach 50%), other targeted molecular approaches need to be developed. Consequently, a number of currently ongoing trials focus on confirming potential n ...
Transarterial chemoembolisation (TACE) delivers a chemotherapeutic agent (usually doxorubicin) into the feeding vessels of a hepatocellular carcinoma (HCC) and blocks the subsequent perfusion of these vessels by the injection of a plugging material. Two randomized controlled trials, conducted 10 years ago, reported a survival advantage for patients with a preserved liver function [1,2]. Subsequent meta-analysis confirmed that TACE increased the survival of patients with HCC [3,4]. TACE is a part ...
BACKGROUND The simultaneous presence of features of pemphigus vulgaris (PV) in patients with bullous pemphigoid (BP) has previously been reported in the literature. OBJECTIVE The purpose of this retrospective study is to present 13 patients with an initial diagnosis of BP, who subsequently demonstrated coexistent serological features of both BP and PV. METHODS The following information on each patient was documented, at the time of initial diagnosis: clinical profile on presentation, histolo ...
OBJECTIVE To evaluate the 3-year incremental cost-effectiveness of fluocinolone acetonide implant versus systemic therapy for the treatment of noninfectious intermediate, posterior, and panuveitis. DESIGN Randomized, controlled, clinical trial. PARTICIPANTS Patients with active or recently active intermediate, posterior, or panuveitis enrolled in the Multicenter Uveitis Steroid Treatment Trial. METHODS Data on cost and health utility during 3 years after randomization were evaluated at 6-m ...
BACKGROUND The authors determined the impact of postmastectomy radiotherapy (PMRT) on overall survival (OS) among patients with pT3N0M0 breast cancer in the National Cancer Data Base. METHODS A total of 3437 patients with pT3N0M0 breast cancer who initially were treated with mastectomy between 2003 and 2011 were identified. Of these women, 1644 (47.8%) received PMRT (67% treated with chest wall RT alone and 33% treated with chest wall and regional lymph node irradiation). Univariable and multi ...
In 1974, Giuliano et al. reported the feasibility of intraoperative sentinel lymph node biopsy (SLNB) with lymphatic mapping using isosulfan blue dye in 170 patients. Since then, many prospective trials have validated this technique as safe and accurate, establishing SLNB as the standard axillary staging procedure in clinically node-negative women even before any randomized trials or long-term outcomes were reported. Historically, the false-negative rate (FNR) of SLNB ranged between 5 and 10 % e ...
Seventeen cases of endobronchial metastases are reviewed. Of these, six had the primary lesion in the breast. Treatment was by resection, radiation, or systemic therapy. Breast cancer patients with long disease-free intervals had the longest survival after bronchial metastases, and those with the most aggressive carcinomas and sarcomas had shorter survival. ...
The cancer stem cell (CSC) hypothesis postulates that a sub-population of quiescent cells exist within tumors which are resistant to conventional cytotoxic/anti-proliferative therapies. It is these CSCs which then seed tumor relapse, even in cases of apparent complete response to systemic therapy. Therefore, therapies, such as immunotherapy, which add a specific anti-CSC strategy to standard cytoreductive treatments may provide a promising new direction for future cancer therapies. CSCs are an a ...
Thymoma is the most common benign neoplasm of the anterior mediastinum presenting often an agressive behaviour typical for the malignants tumors. The rate of invasive thymoma recurrency is relatively high. We present the case of a 55-year old man with a recurrent invasive thymoma with a pleural dissemination, detected on CT-imaging 2 years following his primary surgery. Since the first pre-operative imaging studies showed no invasion of the adjacent organs and a thymoma was suspected, a surgical ...
Multidrug resistance is probably the single greatest obstacle to successful systemic therapy of human cancer. We have reported that cyclosporin A (CsA) can overcome multidrug resistance and improve the efficacy of etoposide in a murine model of drug-sensitive leukemia. The combination of CsA and paclitaxel (PCL) was also significantly superior to either drug alone against murine P388 (sensitive) and L1210 (resistant) leukemia. Lung cancer cells provide an ideal model system to study this phenome ...
Neoadjuvant systemic breast cancer therapy is the administration of systemic therapy to eligible breast cancer patients prior to surgery. This treatment modality was developed out of necessity to downstage inoperable tumors, but it has evolved into a tool for breast conservation surgery. The neoadjuvant approach is also commonly used now to explore the efficacy of new therapeutics by assessing their impact on pathologic complete response or other endpoints. This article will review the foundatio ...
BACKGROUND The costs of psoriasis to a tertiary-level clinic vary considerably depending on the country of study and methods used. Hospitalisation and phototherapy have been significant cost components. This study was performed to estimate the distribution and relative magnitude of the costs of psoriasis to a tertiary-level clinic. METHODS Based on 233 patients, outpatient and phototherapy visits and the days hospitalised were collected from the treatment provider's records. The visit costs re ...
Weichteilsarkome sind seltene Tumoren, die durch ihr vielgestaltiges klinisches Erscheinungsbild und die meist interdisziplinäre Therapiestrategie eine besondere Herausforderung darstellen. Goldstandard für die Behandlung von primär resektablen Weichteilsarkomen ist die Resektion im Gesunden. Bei metastasierten Weichteilsarkomen ist die systemische Therapie von entscheidender Bedeutung. Die wirksamsten Einzelsubstanzen sind Anthrazykline und Ifosfamid. Mit einer Kombinationstherapie werden me ...
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Effective Health Care s Survival rates for women with breast cancer in England and Wales are worse than in most European countries. There is evidence of wide variations in the management of breast cancer within the country. s The speed and cost-effectiveness of accurate diagnosis of breast cancer can be increased by using a combination of clinical examination, mammography and fine needle aspiration cytology (triple assessment). The use of triple assessment will reduce the number of women needing ...
Melanoma is the most dangerous form of skin cancer owing to its metastatic potential and is an important public health concern. The melanoma incidence has been increasing worldwide. Although potentially curable when diagnosed early, metastatic melanoma carries a poor prognosis. Until recently, systemic therapy for metastatic melanoma was ineffective, but the recent successes in the development of new therapies for metastatic melanoma, such as mitogen-activated protein kinase (MAPK) pathway inhib ...
The phase 3 MONALEESA-2 study demonstrated that addition of ribociclib (RIB) to letrozole (LET) significantly improved progression-free survival (PFS) in patients (pts) with hormone receptor-positive (HR+), HER2-negative (HER2−) advanced breast cancer (ABC). Here, we evaluated duration of response (DoR), tumor shrinkage, PFS by treatment-free interval (TFI), and health-related quality of life (HRQoL). Postmenopausal women (N = 668) with HR+ , HER2− ABC and no prior systemic therapy for AB ...
Objective: To facilitate the choice of systemic adjuvant therapy for women with node-positive breast cancer. Evidence: Based on systematic literature review using MEDLINE from 1976 and CANCERLIT from 1983 to May 2000. Nonsystematic review of literature was continued through January 2001. ...
Anti-tumor antibody (317G5) covalently coupled to an anti-CD3 antibody (OKT3) produces a heteroaggregate (HA) antibody that can target PBL to lyse tumor cells expressing the appropriate tumor Ag. The i.v. and i.p. distribution of radiolabeled HA antibody 317G5 x OKT3 and of radiolabeled cultured human PBL were studied in athymic nude mice bearing solid intraperitoneal tumor established from the human colon tumor line, LS174T. Mice were injected with 125I-labeled HA antibody, 125I-labeled anti-tu ...
Lymph node status is a key factor in determining the stage of breast cancer and the most appropriate therapy and for predicting the outcome of patients. Accurate identification of sentinel lymph nodes (SLNs) preoperatively is of clinical importance. Sentinel lymph node biopsy (SLNB) causes less lymph edema of the upper arm than axillary lymph node dissection (ALND) with a high accuracy rate and low false-negative rate (FNR). Neoadjuvant chemotherapy (NAC) can be given not only to patients with l ...
INTRODUCTION Trastuzumab is a key drug in the neoadjuvant treatment of breast cancers that overexpress the human epidermal growth factor receptor 2 (HER2). Pathological complete response (pCR) is commonly used as an endpoint in neoadjuvant clinical trials of trastuzumab as evidence suggests it may be a surrogate for long-term survival. Several biosimilar candidates of originator or 'reference' trastuzumab are in development and have used pCR as a primary endpoint to assess therapeutic equivalenc ...
Traditionally, stage IV metastatic breast cancer has been treated with systemic therapy and/or radiotherapy in order to decrease cancer-associated symptoms, maintain quality of life and control disease burden. Previous research suggests that surgical treatment of the primary tumour may prolong survival, as well achieve local control of disease. Using the PubMed and Ovid SP databases, a literature review and meta-analysis was performed in order to assess whether surgical resection of the primary ...
Primary hyperhidrosis commonly affects the axillae, palms, soles, scalp, face, and groin. Patients may have multiple areas involved making localized therapy challenging. Systemic therapy may be necessary and can be used as monotherapy or combined with other hyperhidrosis treatments for optimal outcomes. Systemic therapy can also be used to treat secondary hyperhidrosis and compensatory hyperhidrosis. ...
AIM Analysis of the development and treatment of bilateral Candida endophthalmitis after induced abortion in a healthy 31-year-old patient. METHOD A diagnosis of bilateral Candida endophthalmitis was established on the basis of positive vaginal culture, serological finding, and culture for Candida hyphae from the vitreous aspirate. The treatment of the disease consisted of prolonged systemic therapy with amphotericin B and fluconazole and pars plana vitrectomy with intravitreal amphotericin B ...
The necessity of screening high-risk patients with breast cancer who may require more intensive systemic therapy especially in the node negative subgroup was generally accepted. Cathepsin D, an estrogen induced protease, has been shown to be implicated in the proliferation and invasion of breast cancers. Retrospective assessment of cytosol cathepsin D in 151 primary breast cancers was done together with ER, PR and other clinico-pathological parameters. No significant relationship was shown betwe ...
This previously unreported Renaissance painting depicts a young woman with locally advanced breast cancer reaching out towards a healing potion in the church of Santa Maria della Grazia in Milan, that houses Leonardo da Vinci's Last supper. Today's potion may well contain neoadjuvant systemic therapy including trastuzumab that may allow breast conserving surgery and targeted intraoperative radiotherapy. ...
Pancreatobiliary malignancies are relatively uncommon and the overall prognosis is poor. Treatment options for advanced disease are limited to systemic therapy for metastatic disease and a combination of systemic therapy and radiation therapy for locally advanced but unresectable tumors. There have been significant advances in the treatment of pancreatobiliary cancers in recent years but the prognosis for patient survival remains disappointingly poor. We review the current treatment options for ...
Recurrence of gliomas is a challenging clinical scenario to treat. There has historically been reluctance among neuro-oncologists to consider re-irradiation owing to concerns regarding toxicity, including the risk of radionecrosis. This overview examines the evidence behind re-irradiation, which is predominately from single institution case series. The development, validation and modification of the Combs prognostic score are outlined. Published data on both fractionated radiotherapy and stereot ...
BACKGROUND The management of renal cell carcinoma (RCC) is evolving toward less extirpative surgery and the use of targeted therapy. The authors set out to provide a benchmark against which emerging therapies should be measured. METHODS A prospective database including clinical and pathological variables for 1632 patients with RCC treated between 1989 and 2005 was queried. Patients were stratified using the University of California-Los Angeles Integrated Staging System (UISS) into low-, interm ...
BACKGROUND Most women with breast cancer who undergo breast-conserving surgery receive whole-breast irradiation. We examined whether the addition of regional nodal irradiation to whole-breast irradiation improved outcomes. METHODS We randomly assigned women with node-positive or high-risk node-negative breast cancer who were treated with breast-conserving surgery and adjuvant systemic therapy to undergo either whole-breast irradiation plus regional nodal irradiation (including internal mammary ...
The incidence of hepatocellular carcinoma (HCC) is increasing in Switzerland and its treatment is a challenge. The purpose of this article is to summarize the different therapeutic approaches in the metastatic stage, as well as the perspectives of targeted treatments and immunotherapy. Until recently, the only recognized therapeutic standard for these patients with metastatic CHC was sorafenib, a tyrosine kinase inhibitor. If the patient was to progress under sorafenib, no other recognized thera ...
BACKGROUND The management of pT1a-b pN0 HER2-positive breast cancer is controversial and no data about the efficacy of trastuzumab in this setting are available from randomized clinical trials. The aims of this retrospective study were to assess how patients are managed in clinical practice in Italy, which clinical or biological characteristics influenced the choice of adjuvant systemic therapy and the outcome of patients. METHODS Data of consecutive patients who underwent surgery from January ...
Following extensive phase II trials of the combination of dacarbazine and interferon-alpha 2a we performed a prospective, randomized, controlled trial of this combination versus dacarbazine alone as systemic therapy for symptomatic, measurable metastatic malignant melanoma. The two treatment arms were well matched for age, sex, performance, status, relapse-free survival, prior therapy and sites of disease. Therapy consisted of dacarbazine given in combination in escalating doses of 200 mg/m2, 40 ...
Non-small cell lung cancer (NSCLC) is a heterogeneous disease, caused by the presence of different clinically relevant molecular subtypes. Genetic mutations are emerging as potential biomarkers of response and treatment selection in patients with NSCLC. Over the past few years, activating mutations of epidermal growth factor receptor (EGFR) have been recognized as the most important predictor of response to EGFR tyrosine kinase inhibitors (TKIs) such as gefitinib and erlotinib and also as a favo ...
BACKGROUND To determine the outcome and patterns of failure in oral cavity cancer (OCC) patients after postoperative intensity modulated radiotherapy (IMRT) with concomitant systemic therapy. METHODS All patients with locally advanced (AJCC stage III/IV) or high-risk OCC (AJCC stage II) who underwent postoperative IMRT at our institution between December 2006 and July 2010 were retrospectively analyzed. The primary endpoint was locoregional recurrence-free survival (LRRFS). Secondary endpoints ...