GLORIA

GEOMAR Library Ocean Research Information Access

X

Ihre E-Mail wurde erfolgreich gesendet. Bitte prüfen Sie Ihren Maileingang.

Leider ist ein Fehler beim E-Mail-Versand aufgetreten. Bitte versuchen Sie es erneut.

Vorgang fortführen?

Exportieren
  • 1
    Online-Ressource
    Online-Ressource
    Bortezomib in Combination with Pegylated Liposomal Doxorubicin and Thalidomide (VDT), An Effective Steroid Independent Regimen for Previously Untreated Multiple Myeloma Patients: Final Result of a Phase II Study.
    American Society of Hematology ; 2009
    In:  Blood Vol. 114, No. 22 ( 2009-11-20), p. 618-618
    Details
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 618-618
    Kurzfassung: Abstract 618 Introduction: Steroids have been an important component of multiple myeloma (MM) therapeutics. High doses steroids as used in MM are associated with significant toxicity and morbidity. Development of steroid independent or steroid-lite regimens remains an important area of investigation in MM. Orlowski et al combined Doxil (D) with bortezomib (V) and showed enhanced anti-myeloma activity. In a phase II study in relapsed refractory MM patients, we observed further improvement in clinical efficacy with addition of thalidomide (T) to VD combination (VDT regimen). Encouraged by high response rates of this steroid sparing novel combination we investigated VDT regimen in treatment naïve MM patients. Final results of this phase II trial are reported here. Methods: Patients with previously untreated MM were eligible for this phase II trial. VDT regimen (V 1.3mg/m2 on days 1, 4,15,18; D 20mg/m2 on days 1,15 and T 200 mg daily continuously) given on a 4-week cycle for a maximum of 8 cycles. Acyclovir (400 mg BID) and weight adjusted low-dose warfarin (1 or 2mg for absolute body weight 〈 70kg or ≥70kg, respectively) was given for prophylaxis of herpes zoster and deep vein thrombosis (DVT), respectively. Response was assessed using the modified Blade criteria. Results: Forty patients (26 males, 14 females; median age 60.5, range 40-80 yrs) were enrolled on this study. Among these 58%(n=23) had stage III (Durie-Salmon) disease with a median b2 microglobulin of 3.7 (range 1.6-16.5 mg/L) and median LDH of 443 (range 152-129 IU/L). Thirty-nine patients are eligible for response evaluation (1 too early for assessment). Overall response rate (CR/nCR+PR) was 79.4% (n=31) with 38% (n=15) patients achieving CR/nCR. The median progression free (PFS) and overall survival (OS) has not been reached. At 1 year the PFS and OS is 81% and 97%, respectively (1 patient died from disease progression to leukemic phase). Toxicity: Neutropenia was the most significant hematological toxicity with grade 3 and 4 neutropenia observed in 22.5% and 2.5% of the patients, respectively. Only 1 (2.2%) patient had febrile neutropenia. Clinically significant neuropathy (grade ≥2) was seen in 20% while grade ≥2 palmer planter erythrodysesthesia was seen in 15% (n=6) of the patients. Other grade 3 non-hematological toxicities included pneumonia (20%), pleural effusion (10%), pulmonary embolism (2%), DVT (2%), congestive heart failure (5%) and interstitial pneumonitis (2%). Conclusion Although effective, steroid based treatment regimen can be associated with significant toxicity especially among patients with concurrent co morbid conditions such as hypertension and diabetes mellitus. Furthermore, recent investigations demonstrate that decreasing steroid doses may actually improve PFS and OS despite a comparatively low initial ORR. In this clinical trial we hypothesized that rational combination of novel myeloma agents may actually preclude the need to rely on high-dose steroids without significantly compromising ORR. Consistent with our expectations, the VDT regimen has ORR comparable to some of the steroid-inclusive triple drug combinations. The toxicity profile of this combination was acceptable and the regimen was well tolerated. Thus we note that VDT is an effective and well tolerated steroid-independent induction regimen for MM patients. Disclosures: Off Label Use: A Phase II study of a novel combination in newly diagnosed myeloma patients. Miller:Celgene: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Millennium: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Czuczman:Centocor Ortho Biotech: Research Funding. Sood:Celgene: Stock. Chanan-Khan:Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Millennium: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Immunogen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.
    Materialart: Online-Ressource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V114.22.618.618
    RVK:
    XA 33000
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Hematology
    Publikationsdatum: 2009
    ZDB Id: 1468538-3
    ZDB Id: 80069-7
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 2
    Online-Ressource
    Online-Ressource
    HLA-identical sibling stem-cell transplantation in first-remission AML
    American Society of Hematology ; 2007
    In:  Blood Vol. 110, No. 13 ( 2007-12-15), p. 4619-4619
    Details
    In: Blood, American Society of Hematology, Vol. 110, No. 13 ( 2007-12-15), p. 4619-4619
    Materialart: Online-Ressource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood-2007-07-100305
    RVK:
    XA 33000
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Hematology
    Publikationsdatum: 2007
    ZDB Id: 1468538-3
    ZDB Id: 80069-7
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 3
    Online-Ressource
    Online-Ressource
    Determining the Extent of Disease with Magnetic Resonance Imaging of the Bone Marrow (BM-MRI) in Patients with Multiple Myeloma (MM).
    American Society of Hematology ; 2007
    In:  Blood Vol. 110, No. 11 ( 2007-11-16), p. 1483-1483
    Details
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 1483-1483
    Kurzfassung: Background: MM remains an incurable cancer. Treatment is often initiated with progressive increase in tumor burden and clinical symptoms. Tumor burden assessment is commonly done by disease stage, presence of lytic bone disease and beta-2 microglobulin (B2M). We investigated bone marrow imaging as a novel approach to quantify disease burden. In a separate report, we observed that MRI is more sensitive than BM aspirate/biopsy (BM-Bx) for assessing extent of marrow involvement in MM patients. In this study we validate that extent of marrow disease detected by BM-MRI correlates with the clinical stage, presence of lytic bone lesions, B2M and secretor vs. non-secretor status of MM patients. Methods: Extent of marrow involvement as evaluated by BM-MRI included sagittal T1 and fast spin echo inversion recovery sequences of the cervical, thoracic and lumbosacral spine and coronal T1 and fast spin echo inversion recovery sequences of the sacrum and pelvic bones. Clinical staging was done as per Durie-Salmon (DS) and the International Staging System (ISS) while lytic bone lesions were assessed by skeletal radiographs. Secretory MM was identified by presence of M-protein in serum or urine by electrophoresis. To study the statistical relationship between pairs of ordinal variables the test corresponding to the Spearman correlation was used and statistical relationship between nominal and ordinal variables was determined by the Wilcoxon or Kruskal-Wallis test. A 0.05 nominal significance level was used in all testing. Following staging system was defined for evaluation of the marrow involvement by BM-MRI: A (0%), B ( & lt; 10%), C (10%–25%), D (26%–50%), E ( & gt; 50%). Results: We evaluated 170 consecutive patients (77 females and 93 males). Median age was 61 years (range 35–83). Advance stage disease ( & gt; stage 1) based on DS or the ISS criteria was observed in 47.6% (n=81) and 53.3% (n=77) patients, respectively. Lytic lesions were noted in 70.6% (n=120) patients and secretory disease in 85.9% (n=146) patients. Estimated Spearman correlation coefficient between BM-MRI involvement and DS stage was 0.2795 (p = 0.0006; 95% CI 0.1222, 0.4368) demonstrating a significant association between BM-MRI involvement and DS stage. This correlation with clinical stage remained significant using the ISS system (p = 0.0001). The correlation of marrow infiltration on BM-MRI was also significantly associated with the presence of lytic bone disease (p & lt;0.0001) as well as the B2M levels (p & lt;0.0001). There was no significant association between MRI involvement and patient age (p = 0.7921) or the Ig type (p=0.8123). Interestingly, marrow involvement on BM-MRI had a significant association with secretor-status of the patients (p=0.0081). Conclusions: BM-MRI is novel approach to quantify disease burden in patients with MM. Our investigation in a large cohort of patients demonstrates that the extent of marrow involvement determined by this method correlates accurately with other conventional methods used to assess myeloma disease burden such as clinical stage, lytic bone disease or B2M. We therefore conclude that BM-MRI can be routinely used to determine disease burden in patients with multiple and can be effectively employed in monitoring response to therapy.
    Materialart: Online-Ressource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V110.11.1483.1483
    RVK:
    XA 33000
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Hematology
    Publikationsdatum: 2007
    ZDB Id: 1468538-3
    ZDB Id: 80069-7
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 4
    Online-Ressource
    Online-Ressource
    Novel Agents Overcome the Adverse Prognosis Imparted by Compromised Renal Function in Patients with Multiple Myeloma
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 2726-2726
    Details
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 2726-2726
    Kurzfassung: INTRODUCTION: Impaired renal function in patients with multiple myeloma (MM) is associated with adverse clinical outcome. Historically, the renal status is reported as serum creatinine (SCr) only. Introduction of novel agents (thalidomide, lenalidomide, bortezomib and pegylated liposomal doxorubicin) in MM therapeutics has improved clinical responses and overall survival. An important question that remains largely unanswered is if these agents deliver equal benefit to patients with impaired renal function. Thus we investigate the overall benefit of novel agents in MM patients with renal impairment. METHODS: All MM patients treated between January 2000 and December 2007 at Roswell Park Cancer Institute (RPCI) where included in this analysis. Extent of disease was assessed based on the Durie-Salmon staging system. We determined glomerular filtration rate (GFR) to asses renal function more accurately. GFR was calculated utilizing the Modification of Diet in Renal Disease (MDRD) equation. Patient cohorts were defined based on severity of renal impairment per the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKD-KDOQI) guidelines based on the GFR value into normal & gt;90, mild 60–89, moderate 30–59, severe 15–29 and kidney failure & lt;15 ml/min/1.73m^2. Because there were only few patients in the last two groups (GFR of 15–29 =11 and GFR & lt;15 =13), they were combined into a single cohort of severe renal impairment (GFR & lt;30=24). We also defined patient cohorts based on a previously reported classification in MM wherein patients were divided based on severity of renal impairment into normal & gt;80, mild 50–80, moderate 30–49 and severe & lt;30 ml/min/1.73m^2. Survival curves and median survival were calculated by Kaplan-Meier method. Survival differences were calculated using a log-rank test. A 0.05 nominal significance level was used in all statistical testing. RESULTS: A total of 175 patients (M=88, F=87) with a median age 60 years (range 34–88) were evaluated. Majority of patients had stage III disease (64%), 57.1% had IgG myeloma and lytic bone disease present in 67.4% of the patients. Median values for SCr, serum calcium, blood urea nitrogen, serum albumin and hemoglobin were 1.1mg/dl (range-0.5–10.3), 9.5 mg/dl (range-7.5- 7.2), 18 mg/dl (range-5–107), 4.0 g/dl (range-2.2–5.5) and 11.5 g/dl (range-6.8–17.1) respectively. SCr & gt;2 mg/dl was seen in only 16% patients and 41.1% patients had GFR in the range of 60–89 ml/min/1.73m^2. Patients received an average of 2 treatments. Use of at least one of the novel agent was seen in 86.3% patients (Immunomodulatory drugs =130, Bortezomib = 97, Pegylated liposomal doxorubicin =65). Median survival for patients with SCr & lt;2.0 and SCr & gt;2.0 was 67.4 months (45.4 – 92.7 months) and 38.4 months (15.3 months – not reached) respectively. Median survival for patients with normal GFR and mild, moderate and severe renal impairment based on the NKD-KDOQI guidelines was 76.1 months (37.5 months – not reached), 55.32 months (34.8 months – not reached), 67.4 months (45.4 months – not reached) and 24.9 months (15.3 months – not reached) respectively. Median survival for patient cohorts defined based on a previously reported classification in MM was similar to that seen with the NKD-KDOQI classification. We noted no significant survival advantage of normal renal function over renally impaired patients (Figure 1 & 2) despite evaluations based either by using the traditional approach of SCr (p=0.15; log rank test) or by more sensitive renal function assessment by GFR (p=0.21; log rank test). CONCLUSIONS: We conclude that in MM patients the previously reported and commonly perceived adverse prognosis imparted by impaired renal function can no longer be validated and that routine incorporation of novel agents has overcome this adverse prognosis. These findings are consistent with the impact of novel agents reported in context with MM with aggressive molecular profiles. Figure 1: Kaplan-Meier curve for survival by serum creatinine (SCr) Figure 1:. Kaplan-Meier curve for survival by serum creatinine (SCr)
    Materialart: Online-Ressource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V112.11.2726.2726
    RVK:
    XA 33000
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Hematology
    Publikationsdatum: 2008
    ZDB Id: 1468538-3
    ZDB Id: 80069-7
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 5
    Online-Ressource
    Online-Ressource
    International Staging System (ISS) Is Superior to Durie-Salmon (DS) Staging in Predicting Overall Mortality in Multiple Myeloma (MM)
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 2745-2745
    Details
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 2745-2745
    Kurzfassung: Background: Despite recent therapeutic advancements, multiple myeloma (MM) remains an incurable disorder. Disease stage is the most commonly used parameter to determine tumor burden, need for treatment initiation and survival outcome. In this context the International Staging System (ISS) proposed in 2005 is considered a good predictor of overall survival (OS) and is reported to be more objective than the previous Durie-Salmon staging system (DSS). To date there has been no direct comparison to determine which of these is superior in predicting OS or mortality. Furthermore, ISS was defined prior to the routine availability of novel agents and primarily included MM patients who had undergone autologous stem cell transplant. Whether ISS has similar predictive value in non-transplant patients has not been reported. We investigated the ability to predict OS and mortality of these two staging systems in non-transplant patients with MM. Methods: All MM patients seen at RPCI between January 2004 and June 2007 were included in the analysis. Clinical staging was done as per the DSS and ISS in all patients. Descriptive baseline demographic data and survival data were collected. A 0.05 nominal significance level was used in all hypothesis testing. Results: A total of 170 consecutive patients were evaluated. None of the patients had undergone a stem cell transplant for their MM diagnosis. Survival data was available on 144 patients which are reported in this analysis. Of these 48% (n=69) were females and 52% (n=75) were males, with a median age of 60 years (range 35–83). The DSS revealed a distribution as follows: stage IA (21; 14.6%), stage IB (1; 0.7%), stage IIA (23; 16%), stage IIB (1; 0.7%), stage IIIA (81; 56.2%) and stage IIIB (17; 11.8%). The distribution as per ISS was stage I (76; 52.8%), stage II (31; 21.5%) and stage III (37; 25.7%). A Cox proportional hazards model was fit to compute a generalized R-square (Gen R2) statistic for the two staging systems and to compute hazard ratios (HR). The Gen R2 for DSS was 0.0259, while for ISS was 0.0461. Thus, by themselves, the two staging systems were not particularly predictive of OS. Comparison was then made by separating stage III (advanced stage disease) from stage I and II for both DSS and ISS. The estimated hazard of death for DSS I/II patients was not significantly different from the estimated hazard of death for DSS III patients (HR=0.48; 95% CI 0.2,1.14; p=0.09), while the estimated hazard of death for ISS I/II patients was significantly different from that for ISS III patients (HR=0.43; 95% CI 0.21,0.85; p=0.01). Exact odds ratios (OR) were computed between dichotomized DSS or ISS stage with patient status at years 1, 2 and 3 of follow up. Survival analysis at 1-year, 2-year and 3-year time point included 112, 93 and 77 patients, respectively. At 1-year, the sample odds of death for stage I/II patients were significantly different from the sample odds of death for stage III patients in both, the DSS (OR=0.32; 95% CI 0.1,0.93; p=0.02) and ISS (OR=0.25; 95% CI 0.08,0.25; p=0.005). At 2-year as well, this difference was significant for both, DSS (OR=0.32; 95% CI 0.1,0.98; p=0.03) and ISS (OR=0.18; 95% CI 0.06,0.63; p=0.002). At 3-year though, the DSS was no longer able to predict a significant difference in the sample odds of death between stage I/II and stage III patients (OR=0.4; 95% CI 0.11,1.34; p=0.11), while the sample odds of death as per the ISS were still significantly different (OR=0.21; 95% CI 0.04, 0.78; p=0.01). Conclusions: Our data from a prospective large cohort of non-transplant MM patients suggests that ISS is more predictive of overall mortality than the DSS. Furthermore, when comparing advanced stage disease (stage III) with early-stage disease (stage I/II), the DSS may only be able to predict short-term survival, while ISS is able to effectively predict survival over a prolonged period. Figure Figure
    Materialart: Online-Ressource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V112.11.2745.2745
    RVK:
    XA 33000
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Hematology
    Publikationsdatum: 2008
    ZDB Id: 1468538-3
    ZDB Id: 80069-7
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 6
    Online-Ressource
    Online-Ressource
    Lenalidomide Associated Tumor Flare Reaction Correlates with Clinical Response in Patients with Relapsed or Refractory B-Cell Chronic Lymphocytic Leukemia
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 4163-4163
    Details
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 4163-4163
    Kurzfassung: INTRODUCTION: We have previously reported that in patients with B-CLL, lenalidomide induces a tumor flare reaction (TFR) that is clinically characterized by painful, tender enlargement of disease involved lymph nodes, spleen and/or liver along with low grade fever. The underlying mechanism as well as the impact of TFR on treatment outcomes remains unknown. We analyzed data from our phase II clinical trial in which the clinical efficacy of lenalidomide alone was investigated in patients with relapsed or refractory B-CLL and correlated the severity of TFR with clinical efficacy. METHODS: Forty five patients with relapsed refractory CLL, enrolled in a phase II study were divided into two groups; group A consisted of first 29 patients who were treated with 25 mg of lenalidomide for 21 days of a 28 day cycle without any prophylaxis for tumor flare reaction, group B consisted of subsequent 16 patients who received 10 mg per day of lenalidomide initially with subsequent escalations of 5 mg every 1–2 weeks to a maximum dose of 25 mg along-prednisone prophylaxis (20 mg/day for 5 days followed by 10 mg/day for 5 days) was given to this group during cycle 1 only. RESULTS: Thirty of the 45 patients (67%) developed clinically significant TFR. Of these 20 (67%) were grade I, 7 (23%) grade II and 3 (10%) grade III. The median time to TFR was 6 days (range 0–56 days). The median time to resolution was 14 days (95% CI: 10–26 days). In over 90% of cases flare occurred only during first treatment cycle. Median age for those who either developed or did not develop flare reaction was 61 and 71 years respectively (p=0.004, 2-sided, Wilcoxon test). Nineteen patients (66%) in group A and 11 (69%) in group B developed TFR. Grade II/III flare was observed in 9 (47%) and 1 (9%) patients in group A and B, respectively (p=0.05). The median time to onset of TFR was 4 days in group A and 9 days in group B (p=0.01). The median duration of TFR was 13 and 28 days in groups A and B respectively (p=0.16). A total of 8 patients achieved molecular complete remission (mCR). All but 1 patient who achieved mCR had a flare reaction (p=0.24). The median progression free survival of patients with or without TFR was 19.9 and 19.4 months, respectively. There was a trend to improvement of progression free survival in group A patients compared to group B patients, 23 vs. 17.8 months, respectively (p=0.74, log rank test), however, this difference did not reach statistical significance. TFR reaction was managed by non-steroidal anti-inflammatory agent with or without oral morphine. Eleven of the 30 patients with TFR required treatment and only 3 patients received supplemental morphine. None of patient required discontinuation of lenalidomide for TFR. CONCLUSION: Although the mechanism of TFR remains to be determined clinically it appears to be an immunologically mediated phenomenon that is uniquely seen in CLL patients. We observe that the occurrence and severity of TFR appears to correlate with clinical response to lenalidomide. Steroid prophylaxis decreases the severity but not the incidence of TFR. The effect on overall efficacy of steroid pre-treatment for prevention of TFR remains to be determined in larger cohort of patients.
    Materialart: Online-Ressource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V112.11.4163.4163
    RVK:
    XA 33000
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Hematology
    Publikationsdatum: 2008
    ZDB Id: 1468538-3
    ZDB Id: 80069-7
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 7
    Online-Ressource
    Online-Ressource
    Erlotinib for Metastatic Non-Small-Cell Lung Cancer: First-, Second- or Third-Line Setting – Does It Matter ?
    S. Karger AG ; 2009
    In:  Oncology Vol. 76, No. 2 ( 2009), p. 85-90
    Details
    In: Oncology, S. Karger AG, Vol. 76, No. 2 ( 2009), p. 85-90
    Kurzfassung: 〈 i 〉 Background: 〈 /i 〉 Erlotinib is approved as treatment for metastatic non-small-cell lung cancer (NSCLC), following failure of initial therapy. Studies to define patients that derive maximal benefit from erlotinib have not dictated current practice. 〈 i 〉 Methods: 〈 /i 〉 We retrospectively analyzed the prescription patterns and outcomes related to erlotinib use for NSCLC in a comprehensive cancer center. 〈 i 〉 Results: 〈 /i 〉 Of 137 consecutive patients treated with erlotinib over 2 years, 116 were evaluable. Median age was 66 years, 63% females, most common histology was adenocarcinoma (n = 58). Seventy-nine patients presented with stage IIIB–IV disease, 37 with recurrent disease. There were 109 smokers. Erlotinib was given first line in 31 (27%), second line in 52 (45%) and third line in 33 (28%) patients. Daily erlotinib dose was 100 mg in 21 (18%) and 150 mg in 91 (82%) patients. Median duration of treatment was 8 weeks (range 1–72). Median overall survival (OS) from initiation of erlotinib was 5.4 months (range 0.2–27.8). There was no significant difference in median survival by disease stage (recurrent vs. de novo IIIB–IV) (p = 0.201), whether erlotinib was used as first-, second-, third-line therapy (p = 0.971) or at different doses (100 vs. 150 mg daily dose) (p = 0.579). 〈 i 〉 Conclusions: 〈 /i 〉 OS after erlotinib use was not different, whether used as first-, second- or third-line therapy, whether patients had recurrent metastatic NSCLC or de novo stage IV disease, or if erlotinib was used at a dose of 100 or 150 mg daily.
    Materialart: Online-Ressource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000187427
    RVK:
    XH 3305
    Sprache: Englisch
    Verlag: S. Karger AG
    Publikationsdatum: 2009
    ZDB Id: 1483096-6
    ZDB Id: 250101-6
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 8
    Online-Ressource
    Online-Ressource
    Bortezomib in Combination with Pegylated Liposomal Doxorubicin and Thalidomide (VDT) for the Treatment of Previously Untreated Multiple Myeloma.
    American Society of Hematology ; 2007
    In:  Blood Vol. 110, No. 11 ( 2007-11-16), p. 3614-3614
    Details
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 3614-3614
    Kurzfassung: Introduction: Orlowski et al were the first to report that addition of PLD resulted in enhanced efficacy of bortezomib. To further optimize the clinical efficacy of these agents we included thalidomide to the regimen. In a previous report we described the clinical efficacy of this novel, non-steroidal regimen that incorporated bortezomib (V), pegylated liposomal doxorubicin (D) and thalidomide (T) in patients with relapsed or refractory multiple myeloma (MM). High clinical responses in heavily pretreated patients, even in the absence of steroids encouraged us to investigate this regimen in previously untreated MM patients. Here we report for the first time the efficacy and toxicity profile of the VDT regimen in treatment naïve MM patients enrolled on a phase II clinical study at our center. METHOD: All previously untreated MM patients were eligible for this study. Bortezomib (1.3mg/m2) was given on days 1, 4, 15, and 18, pegylated liposomal doxorubicin was given (20mg/m2) on days 1 and 15 and thalidomide (200mg) was given everyday continuously throughout the treatment. Patients received treatment on a 4-week cycle. Acyclovir 400mg PO BID and low-dose warfarin was given for prophylaxis of herpes zoster and venous thromboembolism respectively. RESULTS: A total of 26 patients (median age-- 60 range 40–82 years), 16 M and 10 F have so far been enrolled. Advance stage III disease was noted in ---of the patients. The median beta 2 microglobulin was 4 (range1.6–9.7), albumin of 4 (range 3.1–4.8) and LDH was 333 (range 152–1057). Patients received a median of 5 treatment cycles (range 1–8). Toxicity: The most common grade 3 or 4 hematologic toxicities included lymphopenia (27%) and neutropenia (15%), while the non-hematologic toxicity included infections 15% (n=4 patients). The incidence of grade 3 or 4 plantar palmar erythrodysthesia was 4% (n=1). Venous thromboembolism was not observed in any patient to date. Response: To date 17 patients are available for response assessment (EBMT criteria?), 7 patients are too early for response assessment. The ORR of this regimen is 65% with IFE negative CR observed in 3 patients (17.6%). Another 5 patients achieved a stable disease with only 1 progressive disease observed on the regimen so far. Conclusion: VDT is a novel non-steroidal regimen with clinical efficacy in previously untreated myeloma patients. Overall toxicity is manageable. Several patients remain on treatment and currently not evaluable for response. Detailed and updated results of this study will be presented at the meeting.
    Materialart: Online-Ressource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V110.11.3614.3614
    RVK:
    XA 33000
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Hematology
    Publikationsdatum: 2007
    ZDB Id: 1468538-3
    ZDB Id: 80069-7
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 9
    Online-Ressource
    Online-Ressource
    High Body Surface Area (BSA) Is An Independent Risk Factor for Developing Bisphosphonate-Induced Osteonecrosis of the Jaw (ONJ)
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 2786-2786
    Details
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 2786-2786
    Kurzfassung: Background: Osteolytic bone disease and associated complications of pathological fractures is a major complication in patients with multiple myeloma (MM) and metastatic breast cancer (MBC). This is due to tumor cell mediated increase in osteoclastic activity. Bisphosphonates (BP) are effective in preventing skeletal events associated with osteolytic bone destruction. Improved survival of MM and MBC patients has resulted in prolonged exposure to BP therapy, which is reported to be associated with an increased incidence of osteonecrosis of the jaw (ONJ). ONJ involves destruction and necrosis of the maxillary and/or mandibular bone, etiology of which remains unclear. As treatment is usually not helpful, prevention becomes an important strategy and in this context identification of validated risk factors for development of OJN is critical. Several investigators have reported possible risk factors (including invasive dental procedures, prolonged BP therapy and renal dysfunction) that are associated with increased likelihood of ONJ development. We asked if specific patient biometric profile renders enhanced risk of ONJ development? Thus we investigated patient demographic profiles in a large cohort of patients and correlated with development of ONJ. Methods: Patients with MM or MBC with bone lesions treated with intravenous (iv) BP (zoledronic acid; Zometañ) between November 2002–December 2006 were identified using the RPCI database. Demographic, laboratory biochemical, BP-related and ONJ-related data was collected and compared between cases and controls. Results: Complete data was available for 160 patients, of whom 36 (22.5%) patients had ONJ. The remaining 124 (77.5%) patients served as controls. Of all the patients, 122 (76.2%) had MBC and 38 (23.8%) had MM. Median age for all patients was 58 years (range 35–87) while the median age at diagnosis of ONJ was 59.5 years (range 40–81). The median number of cycles with BP for the control group was 15 (range 1–80) and for the ONJ group was 23.5 (range 1–80). Cumulative median BP dose in the control and ONJ groups was 58 mg (range 2–316 mg) and 94 mg (range 4–297 mg) respectively, while the median body surface area (BSA) amongst the control group was 1.66 m2 (range 0.93–2.4) and in the ONJ group was 1.81 m2 (range 1.44–2.5). Other variables studied between cases and controls included percent deviation from ideal body weight, body mass index (BMI) serum creatinine at baseline, creatinine clearance (CrCl) at baseline and at time of diagnosis of ONJ, baseline serum calcium and baseline serum alkaline phosphatase. Amongst the variables tested, BSA was the only factor that was significantly different between the two groups (p=0.004; Wilcoxon). There was no significant difference between CrCl at baseline and at ONJ diagnosis (p=0.73; Sign test). A logistic regression model showed that BSA was significantly different between the cases and controls on univariate analysis (p=0.009) as well as a multivariate analysis incorporating BSA, cumulative BP dose, age at initiation of BP, BMI and baseline creatinine clearance (p=0.028). Using a normal adult BSA of 1.71 m2 as the cut-off, the odds ratio for developing ONJ was 2.85 times (univariate) and 2.54 times (multivariate) higher in the higher than normal BSA group (BSA 3 1.71 m2) when compared with the lesser BSA group (BSA & lt;1.71 m2). Conclusions: ONJ is a serious complication of BP therapy. Patient’s biometric profile has not been implicated as a potential risk factor in ONJ development so far. Our study, for the first time suggests that patient’s BSA may be an important and independent risk factor for BP associated ONJ. Our findings warrant further investigation in prospective studies and emphasize close monitoring of patients with high BSA who are on BP treatment with careful periodic assessment of risk-benefit for BP continuation. Figure Figure
    Materialart: Online-Ressource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V112.11.2786.2786
    RVK:
    XA 33000
    RVK:
    XA 10000
    Sprache: Englisch
    Verlag: American Society of Hematology
    Publikationsdatum: 2008
    ZDB Id: 1468538-3
    ZDB Id: 80069-7
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
  • 10
    Online-Ressource
    Online-Ressource
    Transarterial Chemoembolization in a Patient With Recurrent Hepatocellular Carcinoma and Portal Vein Thrombosis : A Case Report and Review of the Literature
    Ovid Technologies (Wolters Kluwer Health) ; 2005
    In:  American Journal of Clinical Oncology Vol. 28, No. 6 ( 2005-12), p. 638-639
    Details
    In: American Journal of Clinical Oncology, Ovid Technologies (Wolters Kluwer Health), Vol. 28, No. 6 ( 2005-12), p. 638-639
    Materialart: Online-Ressource
    ISSN: 0277-3732
    URL: Article
    DOI: 10.1097/01.coc.0000158488.36371.50
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2005
    ZDB Id: 2043067-X
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    Online-Ressource
Schließen ⊗
Diese Webseite nutzt Cookies und das Analyse-Tool Matomo. Weitere Informationen finden Sie hier...