Supportive cancer therapy最新文献

{"title":"Symptom Burden for Patients with Metastatic Colorectal Cancer Treated with First-Line FOLFOX or FOLFIRI with and Without Bevacizumab in the Community Setting","authors":"Barry V. Fortner ,&nbsp;Lee S. Schwartzberg ,&nbsp;Edward J. Stepanski ,&nbsp;Arthur C. Houts","doi":"10.3816/SCT.2007.n.020","DOIUrl":"10.3816/SCT.2007.n.020","url":null,"abstract":"<div><h3>Background</h3><p>FOLFOX (oxaliplatin/leucovorin/5-fluorouracil) and FOLFIRI (irinotecan/leucovorin/5-fluorouracil) with or without bevacizumab have become standard-of-care regimens in first-line treatment of metastatic colorectal cancer. However, there is a paucity of symptom burden information regarding these regimens from the patient perspective in community oncology.</p></div><div><h3>Patients and Methods</h3><p>This retrospective chart review and telephone interview study examined patients with first-line metastatic colorectal cancer from 5 community oncology centers treated with FOLFOX or FOLFIRI with and without bevacizumab. Patientreported outcomes were taken from the Patient Care Monitor 1.0 Revised, a validated tablet computer–based questionnaire that measures symptom burden and several scales of functioning and quality of life. A subset of patients completed structured telephone interviews about the impact of treatment on practical activities and income.</p></div><div><h3>Results</h3><p>Eighty-eight patients with an average age of 62 years were included. Patients completed a median of 8 cycles of treatment. The most common moderate to severe symptom complaint was fatigue. Gastrointestinal symptoms were common but did not cluster in one regimen versus another. Neuropathyrelated symptoms were also common across all regimens except FOLFIRI without bevacizumab. Nausea and neutropenia were common indications for concomitant medications. One third reported work and other activity interference, and care produced outof-pocket expenditures in excess of $1000.</p></div><div><h3>Conclusion</h3><p>Although sample size was small in the FOLFIRI-based regimens, patient reports and chart records suggested that there was not a systematic difference between FOLFOX and FOLFIRI regimens in type of symptom. The addition of bevacizumab did not appear to increase symptom burden.</p></div>","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 233-240"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/SCT.2007.n.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27539562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary N-Telopeptide Is a Rapid Predictor of Response to and Palliative Benefit from Bisphosphonate Therapy in Patients with Metastatic Breast Cancer","authors":"Christine Simmons ,&nbsp;Reuben J. Broom ,&nbsp;David E.C. Cole ,&nbsp;George Dranitsaris ,&nbsp;Mark Clemons","doi":"10.3816/SCT.2007.n.013","DOIUrl":"10.3816/SCT.2007.n.013","url":null,"abstract":"<div><p>Bone is the most common site of metastases in patients with advanced breast cancer. In these patients, the primary aim of therapy is to prevent and delay the occurrence of skeletal-related events (SREs), which can be defined as follows: (1) pain requiring radiation or surgical intervention, (2) spinal cord compression, (3) pathologic fracture, or (4) hypercalcemia. Unfortunately, determining which patients are at highest risk for an SRE is difficult with current imaging techniques. In contrast, the urinary biomarker of bone resorption, collagen N-telopeptide, is under intensive study after repeat validation as a rapid and reliable predictor of SREs as well as prognosis and survival. Herein, we review this new role of collagen N-telopeptide as a predictor of bone involvement and response to treatment, and of the palliative benefit of bisphosphonate therapy in patients with metastatic breast cancer.</p></div>","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 182-187"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/SCT.2007.n.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27539555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Phase II/III Randomized, Placebo-Controlled, Double-Blind Clinical Trial of Ginger (Zingiber officinale) for Nausea Caused by Chemotherapy for Cancer: A Currently Accruing URCC CCOP Cancer Control Study","authors":"Jane T. Hickok ,&nbsp;Joseph A. Roscoe ,&nbsp;Gary R. Morrow ,&nbsp;Julie L. Ryan","doi":"10.3816/SCT.2007.n.022","DOIUrl":"10.3816/SCT.2007.n.022","url":null,"abstract":"<div><p>Despite the widespread use of 5-HT3 receptor antagonist antiemetics such as ondansetron and granistron, up to 70% of patients with cancer receiving highly emetogenic chemotherapy agents experience postchemotherapy nausea and vomiting. Delayed postchemotherapy nausea (nausea that occurs ≥ 24 hours after chemotherapy administration) and anticipatory nausea (nausea that develops before chemotherapy administration, in anticipation of it) are poorly controlled by currently available antiemetic agents. Scientific studies suggest that ginger (<em>Zingiber officinale</em>) might have beneficial effects on nausea and vomiting associated with motion sickness, surgery, and pregnancy. In 2 small studies of patients with cancer receiving chemotherapy, addition of ginger to standard antiemetic medication further reduced the severity of postchemotherapy nausea. This article describes a phase II/III randomized, dose-finding, placebo-controlled, double-blind clinical trial to assess the efficacy of ginger for nausea associated with chemotherapy for cancer. The study is currently being conducted by private practice oncology groups that are funded by the National Cancer Institute's Community Clinical Oncology Program and affiliated with the University of Rochester Cancer Center Community Clinical Oncology Program Research Base.</p></div>","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 247-250"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/SCT.2007.n.022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27541800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Index","authors":"","doi":"10.1016/S1543-2912(13)60170-8","DOIUrl":"https://doi.org/10.1016/S1543-2912(13)60170-8","url":null,"abstract":"","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 254-263"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1543-2912(13)60170-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92039790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palmar-Plantar Erythrodysesthesia in Patients Receiving Capecitabine and Intratumor Thymidine Phosphorylase and Dihydropyrimidine Dehydrogenase: Is There a Pharmacologic Explanation?","authors":"Muhammad Wasif Saif ,&nbsp;Vinni Juneja ,&nbsp;Glenda Black ,&nbsp;Jennifer Thronton ,&nbsp;Martin R. Johnson ,&nbsp;Robert B. Diasio","doi":"10.3816/SCT.2007.n.017","DOIUrl":"10.3816/SCT.2007.n.017","url":null,"abstract":"<div><h3>Background</h3><p>Palmar-plantar erythordysesthesia (PPE) is the most common toxicity of capecitabine. Preclinical studies have shown that radiation therapy (RT) upregulates thymidine phosphorylase (TP), which could in turn increase the efficacy of capecitabine. Capecitabine is degraded by dihydropyrimidine dehydrogenase (DPD), and a deficiency in this enzyme can increase the toxicity of capecitabine. However, the effect of radiation therapy on frequency of PPE and association with TP and DPD has not been fully characterized.</p></div><div><h3>Patients and Methods</h3><p>Toxicity data were collected prospectively in 33 patients and retrospectively in 25 patients with locally advanced pancreatic cancer enrolled in 3 clinical trials who received capecitabine/RT followed by capecitabine alone. Tumor specimens on 33 patients were procured via endoscopic ultrasonography standards 1 week befoer RT and 2 weeks after RT to evaluate TP and DPD messenger RNA levels. Roche grading was used to assess PPE.</p></div><div><h3>Results</h3><p>Among 58 patients, 14 (24%) developed PPE. The capecitabine group tended to have a higher incidence of PPE than the capecitabine/RT group (17.2% vs. 10.3%; <em>P</em> = .12). Grade 2/3 PPE, was observed in 15.5% of patients receiving capecitabine and 1.7% of patients receiving capecitabine/RT (<em>P</em> = .0078; overall: 17.2%). Median cumulative dose of capecitabine for first development of PPE was 235,000 mg/m² in the capecitabine/RT group, and 3,185,000 mg/m² in the capecitabine group, with the relative frequency of an event occurring in the capecitabine/RT arm versus capecitabine of 0.59. Time to occurrence of first episode of PPE was a median of 5 weeks with capecitabine/RT and 6 weeks with capecitabine. Log-rank test showed that neither age, sex, performance status, nor ethnicity were associated with development of PPE. There was no clear difference in tumor responses of patients who had PPE versus those who did not have PPE. Mean tumor TP level was higher among patients with versus without PPE (275.77 vs. 215.29; <em>P</em> = .32). Mean tumor DPD level was lower among patients with versus without PPE (55.18 vs. 63.58; <em>P</em> = .49). Mean TP-DPD ratio was higher among patients with versus without PPE (10.29 vs. 3.04; <em>P</em> = .31).</p></div><div><h3>Conclusion</h3><p>No significant association of PPE with higher tumor thymidine phosphorylase or lower tumor DPD levels was found. There was no difference in the incidence, severity, or time to occurrence of PPE with capecitabine/RT versus capecitabine, indicating no effect of RT. Further studies to evaluate the underlying mechanism of PPE are required.</p></div>","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 211-218"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/SCT.2007.n.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27539559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Extended Dosing Regimen of Epoetin Alfa 60,000 Units Every 2 Weeks in Anemic Patients with Cancer Receiving Chemotherapy","authors":"Stephanie A. Gregory ,&nbsp;John Xie ,&nbsp;Tomek Szczudlo ,&nbsp;Denise Williams ,&nbsp;Richard C. Woodman ,&nbsp;Francois E. Wilhelm","doi":"10.3816/SCT.2007.n.019","DOIUrl":"10.3816/SCT.2007.n.019","url":null,"abstract":"<div><h3>Purpose</h3><p>This open-label study evaluated the safety and efficacy of epoetin alfa 60,000 U once weekly Initialsly followed by 60,000 U every 2 weeks in anemic patients with cancer receiving chemotherapy.</p></div><div><h3>Patients and Methods</h3><p>Patients receiving weekly or every- 4-weeks chemotherapy regimens for nonmyeloid malignancy and with hemoglobin (Hb) level ≤ 11 g/dL were enrolled. They received epoetin alfa 60,000 U weekly during the Initials dosing phase (IDP) to a target Hb level of 12 g/dL. Patients who did not exhibit target Hb level within 12 weeks were withdrawn. Patients who had a hemogloblin level of 12 g/dL during the IDP entered the extended dosing phase (EDP), where epoetin alfa 60,000 U was administered every 2 weeks. Total maximum study duration was 24 weeks.</p></div><div><h3>Results</h3><p>A total of 129 patients (mean baseline Hb level, 10 g/dL) were enrolled and received ≥ 1 dose of epoetin alfa. Sixty-eight percent of patients had hematopoietic response (Hb increase ≥ 2 g/dL from baseline or Hb level ≥ 12 g/dL during the IDP; primary endpoint). Eighty-four patients entered the EDP; 74 of 84 patients (88%) maintained average Hb level between 11 g/dL and 13 g/dL up to time of withdrawal or study completion. Adverse events were consistent with the underlying disease process and chemotherapy treatment. Six patients (4.7%) in the IDP and 8 patients (9.5%) in the EDP experienced clinically relevant thrombotic vascular events.</p></div><div><h3>Conclusion</h3><p>In this study, approximately 90% of patients receiving an extended dosing regimen of epoetin alfa 60,000 U every 2 weeks were able to maintain Hb level between 11 g/dL and 13 g/dL.</p></div>","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 225-232"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/SCT.2007.n.019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27539561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sunshine and Rash: Testing the Role of Sunscreen to Prevent Epidermal Growth Factor Receptor Inhibitor–Induced Rash","authors":"Aminah Jatoi","doi":"10.3816/SCT.2007.n.015","DOIUrl":"10.3816/SCT.2007.n.015","url":null,"abstract":"<div><p>Most patients who receive epidermal growth factor receptor (EGFR) inhibitors develop a rash. To date, no effective palliative therapy has been developed for these rashes. This review describes the rationale behind N05C4, a placebo-controlled trial of sunscreen as an intervention to prevent EGFR inhibitor–related rash.</p></div>","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 198-202"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/SCT.2007.n.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27539557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topiramate in the Treatment of Neuropathic Pain in Patients with Cancer","authors":"Edmond A. Bendaly ,&nbsp;Carol A. Jordan ,&nbsp;Sandra S. Staehler ,&nbsp;Daniel A. Rushing","doi":"10.3816/SCT.2007.n.021","DOIUrl":"10.3816/SCT.2007.n.021","url":null,"abstract":"<div><h3>Introduction</h3><p>Neuropathic pain has been reported to affect 40%–50% of patients with cancer.</p></div><div><h3>Patients and Methods</h3><p>Consecutive patients selected from the outpatient/adult patient palliative care clinic of the Roudebush Veterans Affairs Medical Center and the Indiana University Palliative Clinic were reviewed. A verbal pain linear analogue assessment scale was used to assess neuropathic pain. Pain medication history was also reviewed in addition to percent pain relief. The following variables were extracted from the medical record: pain characteristics, location, cause, date of initiation of therapy, maximal tolerated dose, pain scores on the visit of optimal tolerated dose, other concurrent medications, number of months of pain before initiation of topiramate therapy, and total duration of topiramate therapy. Decrease in worst, best, and average pain was recorded, as were the development of any adverse effects.</p></div><div><h3>Results</h3><p>Of the 13 patients on second- and third-line therapy, 53.8% had ≥ 30% decrease in worst pain; 69.2% had ≥ 30% decrease in average pain, and 53.8% had ≥ 30% decrease in best pain. Eight of 13 patients (61.5%) experienced adverse effects. Five patients discontinued (38.5%) topiramate because of adverse events.</p></div><div><h3>Conclusion</h3><p>Because our retrospective study showed topiramate to be a beneficial second- and third-line therapy in patients with cancer who did not experience adequate pain control on previous regimens, further prospective studies are needed to establish this medication in the armamentarium of neuropathic cancer pain management.</p></div>","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 241-246"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/SCT.2007.n.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27541799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hitting Our Stride","authors":"Jeffrey Crawford","doi":"10.3816/SCT.2007.n.012","DOIUrl":"10.3816/SCT.2007.n.012","url":null,"abstract":"","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 178-179"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/SCT.2007.n.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27539554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase II Evaluation of Desipramine for the Treatment of Hot Flashes","authors":"Debra L. Barton ,&nbsp;Charles L. Loprinzi ,&nbsp;Pamela Atherton ,&nbsp;Jane Raymond ,&nbsp;Tait Shanafelt ,&nbsp;Stephanie Hines ,&nbsp;Fran Palmieri ,&nbsp;Teresa Rummans ,&nbsp;Alex A. Adjei ,&nbsp;Jeff Sloan","doi":"10.3816/SCT.2007.n.018","DOIUrl":"10.3816/SCT.2007.n.018","url":null,"abstract":"<div><h3>Purpose</h3><p>Newer antidepressants with serotonergic effects reduce hot flashes significantly better than placebo. This pilot study was designed to test the efficacy of desipramine, an older antidepressant targeting norepinephrine, in women desiring therapy for hot flashes and to evaluate the toxicity of desipramine.</p></div><div><h3>Patients and Methods</h3><p>In this nonrandomized trial, eligible women were required to have reported ≥ 14 bothersome hot flashes per week for ≥ 1 month. After an Initials baseline week in which no study medication was taken, participants started with desipramine 25 mg daily, which was titrated to100 mg daily by week 5. The primary endpoint was change from baseline in hot flash frequency and hot flash score. Statistical methods involved paired t tests for continuous variables and Fisher exact tests for categoric variables.</p></div><div><h3>Results</h3><p>Twenty-six patients were enrolled on this study between March 2004 and November 2005. The decrease in mean hot flash frequency over 4 weeks of treatment was 23%, with a 31% reduction in hot flash scores. Seven patients (30%) withdrew early because of toxicities consisting of insomnia, nausea, headaches, and/or feeling frightened.</p></div><div><h3>Conclusion</h3><p>Desipramine did not reduce hot flashes beyond the 25%–30% reduction that would be expected with placebo, based on previous work. Therefore, data from this trial do not support further study of this agent for treatment of hot flashes. It is of physiologic interest that this older antidepressant, classified as a tricyclic, did not achieve a clinically significant reduction in hot flash scores in this pilot trial.</p></div>","PeriodicalId":87798,"journal":{"name":"Supportive cancer therapy","volume":"4 4","pages":"Pages 219-224"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/SCT.2007.n.018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27539560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}