Chemotherapy Drugs
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Bevacizumab Plus Fotemustine As First-Line Treatment in Metastatic Melanoma Patients: Clinical Activity and Modulation of Angiogenesis and Lymphangiogenesis Factors
Published OnlineFirst October 28, 2010; DOI: 10.1158/1078-0432.CCR-10-2363 Clinical Cancer Cancer Therapy: Clinical Research Bevacizumab plus Fotemustine as First-line Treatment in Metastatic Melanoma Patients: Clinical Activity and Modulation of Angiogenesis and Lymphangiogenesis Factors Michele Del Vecchio1, Roberta Mortarini2, Stefania Canova1, Lorenza Di Guardo1, Nicola Pimpinelli3, Mario R. Sertoli4, Davide Bedognetti4, Paola Queirolo5, Paola Morosini6, Tania Perrone7, Emilio Bajetta1, and Andrea Anichini2 Abstract Purpose: To assess the clinical and biological activity of the association of bevacizumab and fotemustine as first-line treatment in advanced melanoma patients. Experimental Design: Previously untreated, metastatic melanoma patients (n ¼ 20) received bevaci- zumab (at 15 mg/kg every 3 weeks) and fotemustine (100 mg/m2 by intravenous administration on days 1, 8, and 15, repeated after 4 weeks) in a multicenter, single-arm, open-label, phase II study. Primary endpoint was the best overall response rate; other endpoints were toxicity, time to progression (TTP), and overall survival (OS). Serum cytokines, angiogenesis, and lymphangiogenesis factors were monitored by multiplex arrays and by in vitro angiogenesis assays. Effects of fotemustine on melanoma cells, in vitro, on vascular endothelial growth factor (VEGF)-C release and apoptosis were assessed by ELISA and flow cytometry, respectively. Results: One complete response, 2 partial responses (PR), and 10 patients with stable disease were observed. TTP and OS were 8.3 and 20.5 months, respectively. Fourteen patients experienced adverse events of toxicity grade 3–4. Serum VEGF-A levels in evaluated patients (n ¼ 15) and overall serum proangiogenic activity were significantly inhibited. A significant reduction in VEGF-C levels was found in several post-versus pretherapy serum samples. -
Photoaging & Skin Damage
Use_for_Revised_OFC_Only_2006_PhotoagingSkinDamage 5/21/13 9:11 AM Page 2 PEORIA (309) 674-7546 MORTON (309) 263-7546 GALESBURG (309) 344-5777 PERU (815) 224-7400 NORMAL (309) 268-9980 CLINTON, IA (563) 242-3571 DAVENPORT, IA (563) 344-7546 SoderstromSkinInstitute.comsoderstromskininstitute.com FROMFrom YOUR Your DERMATOLOGISTDermatologist [email protected]@skinnews.com PHOTOAGING & SKIN DAMAGE Before You Worship The Sun Who’s At Risk? Today, many researchers and dermatologists Skin types that burn easily and tan rarely are believe that wrinkling and aging changes of the skin much more susceptible to the ravages of the sun on the are much more related to sun damage than to age! skin than are those that tan easily, rather than burn. Many of the signs of skin damage from the sun are Light complected, blue-eyed, red-haired people such as pictured on these pages. The decrease in the ozone Swedish, Irish, and English, are usually more suscep- layer, increasing the sun’s intensity, and the increasing tible to photo damage, and their skin shows the signs sun exposure among our population – through work, of photo damage earlier in life and in a more pro- sports, sunbathing and tanning parlors – have taken a nounced manner. Dark complexions give more protec- tremendous toll on our skin. Sun damage to the skin tion from light and the sun. ranks with other serious health dangers of smoking, alcohol, and increased cholesterol, and is being seen in younger and younger people. NO TAN IS A SAFE TAN! Table of Contents Sun Damage .............................................Pg. 1 Skin Cancer..........................................Pgs. 2-3 Mohs Micrographic Surgery ......................Pg. -
Results of the Randomized Phase IIB ADMIRE Trial of FCR with Or Without Mitoxantrone in Previously Untreated CLL
Leukemia (2017) 31, 2085–2093 © 2017 Macmillan Publishers Limited, part of Springer Nature. All rights reserved 0887-6924/17 www.nature.com/leu ORIGINAL ARTICLE Results of the randomized phase IIB ADMIRE trial of FCR with or without mitoxantrone in previously untreated CLL T Munir1,12, DR Howard2,12, L McParland2, C Pocock3, AC Rawstron4, A Hockaday2, A Varghese1, M Hamblin5, A Bloor6, A Pettitt7, C Fegan8, J Blundell9, JG Gribben10, D Phillips2 and P Hillmen11 ADMIRE was a multicenter, randomized-controlled, open, phase IIB superiority trial in previously untreated chronic lymphocytic leukemia. Conventional front-line therapy in fit patients is fludarabine, cyclophosphamide and rituximab (FCR). Initial evidence from non-randomized phase II trials suggested that the addition of mitoxantrone to FCR (FCM-R) improved remission rates. Two hundred and fifteen patients were recruited to assess the primary end point of complete remission (CR) rates according to International Workshop on Chronic Lymphocytic Leukemia criteria. Secondary end points were progression-free survival (PFS), overall survival (OS), overall response rate, minimal residual disease (MRD) negativity and safety. At final analysis, CR rates were 69.8 FCR vs 69.3% FCM-R (adjusted odds ratio (OR): 0.97; 95% confidence interval (CI): (0.53–1.79), P = 0.932). MRD-negativity rates were 59.3 FCR vs 50.5% FCM-R (adjusted OR: 0.70; 95% CI: (0.39–1.26), P = 0.231). During treatment, 60.0% (n = 129) of participants received granulocyte colony-stimulating factor as secondary prophylaxis for neutropenia, a lower proportion on FCR compared with FCM-R (56.1 vs 63.9%). -
Gy Total Body Irradiation Followed by Allogeneic Hematopoietic St
Bone Marrow Transplantation (2009) 44, 785–792 & 2009 Macmillan Publishers Limited All rights reserved 0268-3369/09 $32.00 www.nature.com/bmt ORIGINAL ARTICLE Fludarabine, amsacrine, high-dose cytarabine and 12 Gy total body irradiation followed by allogeneic hematopoietic stem cell transplantation is effective in patients with relapsed or high-risk acute lymphoblastic leukemia F Zohren, A Czibere, I Bruns, R Fenk, T Schroeder, T Gra¨f, R Haas and G Kobbe Department of Haematology, Oncology and Clinical Immunology, Heinrich Heine-University, Du¨sseldorf, Germany In this prospective study, we examined the toxicity and Introduction efficacy of an intensified conditioning regimen for treatment of patients with relapsed or high-risk acute The use of intensified conventional induction chemothera- lymphoblastic leukemia who undergo allogeneic hemato- pies in the treatment of newly diagnosed ALL in adult poietic stem cell transplantation. Fifteen patients received patients has led to initial CR rates of up to 90%. But, as fludarabine 30 mg/m2, cytarabine 2000 mg/m2, amsacrine some patients are even refractory to first-line therapy, the 100 mg/m2 on days -10, -9, -8 and -7, anti-thymocyte majority of the responding patients unfortunately suffer globulin (ATG-Fresenius) 20 mg/kg body weight on days from relapse. Therefore, the probability of long-term -6, -5 and -4 and fractionated total body irradiation disease-free survival is o30%.1–5 Risk stratification based 2 Â 2 Gy on days -3, -2 and -1 (FLAMSA-ATG-TBI) on prognostic factors allows identification of high-risk before allogeneic hematopoietic stem cell transplantation. ALL patients with poor prognosis.6–12 Myeloablative At the time of hematopoietic stem cell transplantation, 10 conditioning therapy followed by allogeneic hematopoietic patients were in complete remission (8 CR1; 2 CR2), 3 stem cell transplantation (HSCT) is currently the treatment with primary refractory and 2 suffered from refractory of choice for these high-risk patients.13–15 A combination of relapse. -
Cyclophosphamide-Etoposide PO Ver
Chemotherapy Protocol LYMPHOMA CYCLOPHOSPHAMIDE-ETOPOSIDE ORAL Regimen Lymphoma – Cyclophosphamide-Etoposide PO Indication Palliative treatment of malignant lymphoma Toxicity Drug Adverse Effect Cyclophosphamide Dysuria, haemorrragic cystitis (rare), taste disturbances Etoposide Alopecia, hyperbilirubinaemia The adverse effects listed are not exhaustive. Please refer to the relevant Summary of Product Characteristics for full details. Patients diagnosed with Hodgkin’s Lymphoma carry a lifelong risk of transfusion associated graft versus host disease (TA-GVHD). Where blood products are required these patients must receive only irradiated blood products for life. Local blood transfusion departments must be notified as soon as a diagnosis is made and the patient must be issued with an alert card to carry with them at all times. Monitoring Drugs FBC, LFTs and U&Es prior to day one of treatment Albumin prior to each cycle Dose Modifications The dose modifications listed are for haematological, liver and renal function and drug specific toxicities only. Dose adjustments may be necessary for other toxicities as well. In principle all dose reductions due to adverse drug reactions should not be re-escalated in subsequent cycles without consultant approval. It is also a general rule for chemotherapy that if a third dose reduction is necessary treatment should be stopped. Please discuss all dose reductions / delays with the relevant consultant before prescribing, if appropriate. The approach may be different depending on the clinical circumstances. Version 1.1 (Jan 2015) Page 1 of 6 Lymphoma- Cyclophosphamide-Etoposide PO Haematological Dose modifications for haematological toxicity in the table below are for general guidance only. Always refer to the responsible consultant as any dose reductions or delays will be dependent on clinical circumstances and treatment intent. -
Clinical Outcome of FLAG-IDA Chemotherapy Sequential
Bone Marrow Transplantation (2019) 54:458–464 https://doi.org/10.1038/s41409-018-0283-5 ARTICLE Clinical outcome of FLAG-IDA chemotherapy sequential with Flu–Bu3 conditioning regimen in patients with refractory AML: a parallel study from Shanghai Institute of Hematology and Institut Paoli-Calmettes 1 2 3 2 3 2 1 Ling Wang ● Raynier Devillier ● Ming Wan ● Justine Decroocq ● Liang Tian ● Sabine Fürst ● Li-Ning Wang ● 2 1 2 1 Norbert Vey ● Xing Fan ● Didier Blaise ● Jiong Hu Received: 23 January 2018 / Revised: 28 June 2018 / Accepted: 30 June 2018 / Published online: 6 August 2018 © The Author(s) 2018. This article is published with open access Abstract The purpose of the study was to evaluate the feasibility of conditioning regimen with sequential chemotherapy (FLAG-IDA), followed by Fludarabine (5 days) + Busulfan (3 days) by parallel analysis of patients with refractory acute myeloid leukemia (AML) from two transplantation centers in China and France. A total of 47 refractory AML with median bone marrow blast of 35% (1–90%) and median age at 42 years (16–62) were enrolled. Thirteen patients received peripheral stem cell 1234567890();,: 1234567890();,: transplantation (HSCT) from HLA-matched sibling donor, while 18 and 16 from unrelated or haplo-identical donors, respectively. With a median follow-up of 24.3 months (1–70), 13 patients relapsed at a median time of 5.1 months (2.2–18.0) and 24 patients died due to relapse (n = 12) or non-relapsed mortality (NRM, n = 12). The estimated 3-year RR and NRM were 33.5 ± 5.7% and 25.7 ± 4.2%, respectively. -
Late Stent Thrombosis After Paclitaxel-Eluting Stent Placement in a Patient with Essential Thrombocytosis
558 Türk Kardiyol Dern Arş - Arch Turk Soc Cardiol 2010;38(8):558-560 Late stent thrombosis after paclitaxel-eluting stent placement in a patient with essential thrombocytosis Esansiyel trombositozlu bir hastada paklitaksel salınımlı stent yerleştirme sonrası gelişen geç stent trombozu Telat Keleş, M.D., Nihal Akar Bayram, M.D., Tahir Durmaz, M.D., Engin Bozkurt, M.D. Department of Cardiology, Ankara Atatürk Education and Research Hospital, Ankara We report on a case of late stent thrombosis after drug- Bu yazıda, esansiyel trombositozlu bir hastada ilaç sa- eluting stent placement in a patient with essential throm- lınımlı stent yerleştirme sonrası gelişen geç stent trom- bocytosis. A 51-year-old male patient with a three-month bozu sunuldu. Üç ay önce sol ön inen artere paklitak- history of paclitaxel-eluting stent placement to the left sel salınımlı stent yerleştirilen 51 yaşındaki erkek hasta anterior descending artery presented with a complaint şiddetli retrosternal göğüs ağrısı yakınmasıyla başvur- of severe retrosternal chest pain. A high platelet count du. İki ay öncesinde hastanın trombosit sayımı yüksek (1,063,000/mm3) was detected two months prior to (1063000/mm3) bulunmuş ve durumu esansiyel trombo- presentation, which was interpreted as essential throm- sitoz olarak yorumlanmıştı. Hasta standart ikili antitrom- bocytosis. He was on standard dual antiplatelet therapy bosit tedavi (aspirin ve klopidogrel) görmekteydi. Elekt- (aspirin and clopidogrel). The electrocardiogram showed rokardiyografide V1-V6 derivasyonlarında ST-segment ST-segment elevation in leads V1-V6. Emergent coro- yükselmesi izlendi. Acil koroner anjiyografide paklitaksel nary angiography revealed thrombotic total occlusion salınımlı stent yerinde trombotik tam tıkanıklık gözlendi. at the location of the paclitaxel-eluting stent. -
BC Cancer Protocol Summary for Treatment of Lymphoma with Dose- Adjusted Etoposide, Doxorubicin, Vincristine, Cyclophosphamide
BC Cancer Protocol Summary for Treatment of Lymphoma with Dose- Adjusted Etoposide, DOXOrubicin, vinCRIStine, Cyclophosphamide, predniSONE and riTUXimab with Intrathecal Methotrexate Protocol Code LYEPOCHR Tumour Group Lymphoma Contact Physician Dr. Laurie Sehn Dr. Kerry Savage ELIGIBILITY: One of the following lymphomas: . Patients with an aggressive B-cell lymphoma and the presence of a dual translocation of MYC and BCL2 (i.e., double-hit lymphoma). Histologies may include DLBCL, transformed lymphoma, unclassifiable lymphoma, and intermediate grade lymphoma, not otherwise specified (NOS). Patients with Burkitt lymphoma, who are not candidates for CODOXM/IVACR (such as those over the age of 65 years, or with significant co-morbidities) . Primary mediastinal B-cell lymphoma Ensure patient has central line EXCLUSIONS: . Cardiac dysfunction that would preclude the use of an anthracycline. TESTS: . Baseline (required before first treatment): CBC and diff, platelets, BUN, creatinine, bilirubin. ALT, LDH, uric acid . Baseline (required, but results do not have to be available to proceed with first treatment): results must be checked before proceeding with cycle 2): HBsAg, HBcoreAb, . Baseline (optional, results do not have to be available to proceed with first treatment): HCAb, HIV . Day 1 of each cycle: CBC and diff, platelets, (and serum bilirubin if elevated at baseline; serum bilirubin does not need to be requested before each treatment, after it has returned to normal), urinalysis for microscopic hematuria (optional) . Days 2 and 5 of each cycle (or days of intrathecal treatment): CBC and diff, platelets, PTT, INR . For patients on cyclophosphamide doses greater than 2000 mg: Daily urine dipstick for blood starting on day cyclophosphamide is given. -
Idelalisib Post Allogeneic Hematopoietic Stem Cell Transplant (Hsct) in B Cell Derived Malignancies: a Phase 1 Double Blinded Randomized Placebo Toxicity Trial
Johns Hopkins Protocol ID: J1633 IND: 131805 IDELALISIB POST ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANT (HSCT) IN B CELL DERIVED MALIGNANCIES: A PHASE 1 DOUBLE BLINDED RANDOMIZED PLACEBO TOXICITY TRIAL Principal Investigator: Douglas E. Gladstone, MD Associate Professor of Oncology CRB I, Room 287 1650 Orleans Street Baltimore, MD 21287 [email protected] Co-Investigators: Javier Bolanos Meade, MD Richard Jones, MD Richard Ambinder. MD Lode Swinnen, MD Statisticians: Marianna Zahurak Study Site: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins IRB Number: IRB00157704 IND: 131805 Version Date: February 3, 2020 Version Date: February 3, 2020 Page 1 of 31 Johns Hopkins Protocol ID: J1633 IND: 131805 Version Date: February 3, 2020 Page 2 of 31 Johns Hopkins Protocol ID: J1633 IND: 131805 CONTENTS 1. Introduction................................................................................................................................... 5 1.1. Hypothesis ..................................................................................................................................... 6 2. Objectives ...................................................................................................................................... 6 2.1. Primary Endpoint ........................................................................................................................... 6 2.2. Secondary Endpoint ...................................................................................................................... 6 -
Expanded and Activated Allogeneic NK Cells Are Cytotoxic Against B
www.nature.com/scientificreports OPEN Expanded and activated allogeneic NK cells are cytotoxic against B‑chronic lymphocytic leukemia (B‑CLL) cells with sporadic cases of resistance Tania Calvo1,8, Chantal Reina‑Ortiz1,8, David Giraldos1, María Gascón1, Daniel Woods1, Judit Asenjo2, Joaquín Marco‑Brualla1, Gemma Azaceta3, Isabel Izquierdo4, Luis Palomera3, Diego Sánchez‑Martínez5,6, Isabel Marzo1, Javier Naval1, Carlos Vilches2, Martín Villalba5,6 & Alberto Anel1,7* Adoptive transfer of allogeneic natural killer (NK) cells is becoming a credible immunotherapy for hematological malignancies. In the present work, using an optimized expansion/activation protocol of human NK cells, we generate expanded NK cells (eNK) with increased expression of CD56 and NKp44, while maintaining that of CD16. These eNK cells exerted signifcant cytotoxicity against cells from 34 B‑CLL patients, with only 1 sample exhibiting resistance. This sporadic resistance did not correlate with match between KIR ligands expressed by the eNK cells and the leukemic cells, while cells with match resulted sensitive to eNK cells. This suggests that KIR mismatch is not relevant when expanded NK cells are used as efectors. In addition, we found two examples of de novo resistance to eNK cell cytotoxicity during the clinical course of the disease. Resistance correlated with KIR‑ligand match in one of the patients, but not in the other, and was associated with a signifcant increase in PD‑L1 expression in the cells from both patients. Treatment of one of these patients with idelalisib correlated with the loss of PD‑L1 expression and with re‑sensitization to eNK cytotoxicity. We confrmed the idelalisib‑induced decrease in PD‑L1 expression in the B‑CLL cell line Mec1 and in cultured cells from B‑CLL patients. -
(Rituxan®), Rituximab-Abbs (Truxima®), Rituximab-Pvvr (Ruxience®) Prior Authorization Drug Coverage Policy
1 Rituximab Products: Rituximab (Rituxan®), Rituximab-abbs (Truxima®), Rituximab-pvvr (Ruxience®) Prior Authorization Drug Coverage Policy Effective Date: 2/1/2021 Revision Date: n/a Review Date: 7/2/20 Lines of Business: Commercial Policy type: Prior Authorization This Drug Coverage Policy provides parameters for the coverage of rituximab (Rituxan®), rituximab-abbs (Truxima®), and rituximab-pvvr (Ruxience®). Consideration of medically necessary indications are based upon U.S. Food and Drug Administration (FDA) indications, recommended uses within the Centers of Medicare & Medicaid Services (CMS) five recognized compendia, including the National Comprehensive Cancer Network (NCCN) Drugs & Biologics Compendium (Category 1 or 2A recommendations), and peer-reviewed scientific literature eligible for coverage according to the CMS, Medicare Benefit Policy Manual, Chapter 15, section 50.4.5 titled, “Off- Label Use of Anti-Cancer Drugs and Biologics.” This policy evaluates whether the drug therapy is proven to be effective based on published evidence-based medicine. Drug Description1-3 Rituximab (Rituxan®), rituximab-abbs (Truxima®), and rituximab-pvvr (Ruxience®) are monoclonal antibodies that target the CD20 antigen expressed on the surface of pre-B and mature B- lymphocytes. Upon binding to cluster of differentiation (CD) 20, rituximab mediates B-cell lysis. Possible mechanisms of cell lysis include complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC). B cells are believed to play a role in the pathogenesis of rheumatoid arthritis (RA) and associated chronic synovitis. In this setting, B cells may be acting at multiple sites in the autoimmune/inflammatory process, including through production of rheumatoid factor (RF) and other autoantibodies, antigen presentation, T-cell activation, and/or proinflammatory cytokine production. -
Monotherapy with Pixantrone in Histologically Confirmed Relapsed Or
research paper Monotherapy with pixantrone in histologically confirmed relapsed or refractory aggressive B-cell non-Hodgkin lymphoma: post-hoc analyses from a phase III trial Ruth Pettengell,1 Catherine Sebban,2 This post hoc analysis of a phase 3 trial explored the effect of pixantrone in Pier Luigi Zinzani,3 Hans Gunter patients (50 pixantrone, 47 comparator) with relapsed or refractory aggres- 4 5 Derigs, Sergey Kravchenko, Jack W. sive B-cell non-Hodgkin lymphoma (NHL) confirmed by centralized histo- 6 7 Singer, Panteli Theocharous, Lixia logical review. Patients received 28-d cycles of 85 mg/m2 pixantrone 7 8 Wang, Mariya Pavlyuk, Kahina M. dimaleate (equivalent to 50 mg/m2 in the approved formulation) on days Makhloufi8 and Bertrand Coiffier9,10 1, 8 and 15, or comparator. The population was subdivided according to 1St George’s University of London, London, UK, 2 previous rituximab use and whether they received the study treatment as Leon Berard Cancer Centre, Lyon, France, – 3Institute of Haematology “Le A Seragnoli”, 3rd or 4th line. Median number of cycles was 4 (range, 2 6) with pix- – University of Bologna, Bologna, Italy, 4St€adt Kli- antrone and 3 (2 6) with comparator. In 3rd or 4th line, pixantrone was Á Á nikum, Frankfurt-Hoeschest, Klinik fur€ Innere associated with higher complete response (CR) (23 1% vs. 5 1% compara- Medizin III, Frankfurt am Main, Germany, tor, P = 0Á047) and overall response rate (ORR, 43Á6% vs. 12Á8%, 5Chemotherapy and Intensive Treatment of Hae- P = 0Á005). In 3rd or 4th line with previous rituximab (20 pixantrone, 18 matology Diseases, Haematology Scientific Centre comparator), pixantrone produced better ORR (45Á0% vs.