Clinical medicine. Oncology最新文献

{"title":"Docetaxel as salvage therapy in highly pretreated and drug resistant gastrointestinal carcinomas.","authors":"Martin F Sprinzl,&nbsp;Sonia M Wytopil,&nbsp;Anja Dahmen,&nbsp;Stephan Kanzler,&nbsp;Peter R Galle,&nbsp;Markus Moehler","doi":"10.4137/cmo.s919","DOIUrl":"https://doi.org/10.4137/cmo.s919","url":null,"abstract":"<p><strong>Introduction: </strong>Despite many efforts to develop new chemotherapies for metastatic upper gastrointestinal (GI) cancer, overall prognosis continues to be fatal, particularly in gastric and pancreatic cancer. Many of these patients deserve second-or third-line treatment after failure of first-line chemotherapy. Therefore, we analysed toxicity and response rate of weekly docetaxel after failed upfront regimes in these upper GI cancer patients.</p><p><strong>Patients and methods: </strong>Between 2001 and 2006, 18 patients received docetaxel based regimes (35 mg/m(2) weekly) after informed consent. Response rates were determined using RECIST criteria or tumor progression if clinically evident. Toxicities were graded based on NCI CTC criteria (version 2). Most patients had gastric cancer (13/18). The remaining entities comprised of bilio-pancreatic cancer (5/18).</p><p><strong>Results: </strong>Docetaxel was administered as 2nd line therapy in 28% (5/18), 3rd line therapy in 56% (10/18) and 4th or 5th line therapy in 17% (3/18). The average docetaxel dose was 38 mg/m(2) (Median: 35 mg/m(2)) once weekly. Over a treatment duration of 14.7 weeks, the average dosage was 58 gr per patient and week. Overall, docetaxel was well tolerated with only few chemotherapy-associated toxicities (Grade 3/4), including nausea (17%), polyneuropathy (17%), anorexia (11%), neutropenia (6%) and leukopenia (17%). Docetaxel administration did not achieve any complete responses (CR) and one (5.6%) partial response (PR) was seen (1/18). In addition 5 patients (27.8%) had stable disease (SD), thus inducing a tumor control rate of 33.3% (6/18). Median progression-free survival was 2.4 months for all patients, 2.1 months in the gastric-cancer and 2.4 months in the bilio-pancreatic cancer subgroups respectively. After first docetaxel administration median survival for all patients was 4.5 months, patients with gastric cancer survived for 4.9 months whereas patients suffering from bilio-pancreatic carcinoma survived for 4.2 months. However, taken together 27% (5/18) had a remarkable overall survival of more than 2.5 years.</p><p><strong>Discussion: </strong>In severely pretreated patients, with documented chemoresistant GI tumors, weekly docetaxel was well tolerated, presented good tumor control rate and overall survival. Therefore, this regimen may be used as salvage treatment in individual patients with upper GI cancers.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"555-61"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s919","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30120343","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":"Leptomeningeal metastases in a patient with an extragonadal germ cell tumor.","authors":"Yoshiaki Kinebuchi,&nbsp;Masakuni Ishikawa,&nbsp;Osamu Ishizuka,&nbsp;Osamu Nishizawa,&nbsp;Kazuhiro Hongo","doi":"10.4137/cmo.s687","DOIUrl":"https://doi.org/10.4137/cmo.s687","url":null,"abstract":"<p><p>We present a case of leptomeningeal metastases in a 30-year-old man with an extragonadal germ cell tumor. The patient was referred to our hospital for treatment of an occipital brain metastasis. This lesion was resected, followed by whole brain radiotherapy and further chemotherapy, and a temporary complete remission was achieved. However, leptomeningeal recurrence developed, and despite salvage chemotherapy, the patient died of disease. Although multidisciplinary treatment is given to treat brain metastases of germ cell tumors, the patients' prognosis has been unsatisfactory. The identification of a standard/effective treatment is required.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"371-4"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s687","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30120477","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":"Review: mitochondrial defects in breast cancer.","authors":"Josefa Salgado,&nbsp;Beatriz Honorato,&nbsp;Jesús García-Foncillas","doi":"10.4137/cmo.s524","DOIUrl":"https://doi.org/10.4137/cmo.s524","url":null,"abstract":"<p><p>Mitochondria play important roles in cellular energy metabolism, free radical generation, and apoptosis. Mitochondrial DNA has been proposed to be involved in carcinogenesis because of its high susceptibility to mutations and limited repair mechanisms in comparison to nuclear DNA. Breast cancer is the most frequent cancer type among women in the world and, although exhaustive research has been done on nuclear DNA changes, several studies describe a variety of mitochondrial DNA alterations present in breast cancer. In this review article, we to provide a summary of the mitochondrial genomic alterations reported in breast cancer and their functional consequences.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"199-207"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s524","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30121212","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":"Signal transduction involving the dmp1 transcription factor and its alteration in human cancer.","authors":"Takayuki Sugiyama,&nbsp;Donna P Frazier,&nbsp;Pankaj Taneja,&nbsp;Robert D Kendig,&nbsp;Rachel L Morgan,&nbsp;Lauren A Matise,&nbsp;Sarah J Lagedrost,&nbsp;Kazushi Inoue","doi":"10.4137/cmo.s548","DOIUrl":"https://doi.org/10.4137/cmo.s548","url":null,"abstract":"<p><p>Dmp1 (cyclin D-interacting myb-like protein 1; also called Dmtf1) is a transcription factor that has been isolated in a yeast two-hybrid screen through its binding property to cyclin D2. Dmp1 directly binds to and activates the Arf promoter and induces Arf-p53-dependent cell cycle arrest in primary cells. D-type cyclins usually inhibit Dmp1-mediated transcription in a Cdk-independent fashion; however, Dmp1 shows synergistic effects with D-cyclins on the Arf promoter. Ras or Myc oncogene-induced tumor formation is accelerated in both Dmp1(+/-) and Dmp1(-/-) mice with no significant differences between Dmp1(+/-) and Dmp1(-/-). Thus, Dmp1 is haplo-insufficient for tumor suppression. Tumors from Dmp1(-/-) or Dmp1(+/-) mice often retain wild-type Arf and p53, suggesting that Dmp1 is a physiological regulator of the Arf-p53 pathway. The Dmp1 promoter is activated by oncogenic Ras-Raf signaling, while it is repressed by physiological mitogenic stimuli, overexpression of E2F proteins, and genotoxic stimuli mediated by NF-κB. The human DMP1 gene (hDMP1) is located on chromosome 7q21 and is hemizygously deleted in approximately 40% of human lung cancers, especially those that retain normal INK4a/ARF and P53 loci. Thus, hDMP1 is clearly involved in human carcinogenesis, and tumors with hDMP1 deletion may constitute a discrete disease entity.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"209-19"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30121214","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":"Long survival in a patient with brain metastases from breast cancer.","authors":"Sanna G, Petralia G, Cossu Rocca M, Marenghi C, Nolè F","doi":"10.4137/cmo.s317","DOIUrl":"10.4137/cmo.s317","url":null,"abstract":"<p><p>The incidence of brain metastases (BMs) is apparently rising in patients with advanced breast cancer, possibly due to better therapeutic approaches for control of metastatic growth in other organs. Occurrence of BMs severely affects quality of life and is associated with dire prognosis. In this short report we describe the clinical case of a 47 year old woman, with BMs from breast cancer diagnosed in May 2001. The patient was treated with whole brain irradiation and radiosurgery, with initial control of BMs. Due to previous radiotherapy fields and doses, further local treatments are not feasible anymore. Since September 2006, the patient has been receiving systemic therapy with Lapatinib at the dose of 1500 mg/die continuously, with a good control of cerebral, liver and nodal metastasis after one year of treatment (September 2007). Her quality of life is acceptable, her Karnofsky Performance Status (KPS) is more than 70%, and she takes care of her family, and has not experienced neuro-cognitive dysfunction.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"103-8"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3161678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29975341","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":"Pemetrexed, Carboplatin, and Concomitant Radiation followed by Surgery for Locally Advanced Esophageal Cancer: Results of a Planned Interim Toxicity Analysis of North Central Cancer Treatment Group Study N044E.","authors":"Rajini Katipamula,&nbsp;Aminah Jatoi,&nbsp;Nathan R Foster,&nbsp;Francis Nichols,&nbsp;Joseph Rubin,&nbsp;Matthew Callister,&nbsp;Leonard Gunderson,&nbsp;Steven Alberts","doi":"10.4137/cmo.s444","DOIUrl":"https://doi.org/10.4137/cmo.s444","url":null,"abstract":"<p><strong>Purpose: </strong>This brief report describes a planned, interim, 6-patient toxicity analysis that confirms the safety of pemetrexed, carboplatin, radiation with subsequent surgery, as prescribed in the North Central Cancer Treatment Group trial N044E, in patients with locally advanced esophageal cancer.</p><p><strong>Methods: </strong>Six patients with locally advanced, potentially resectable esophageal cancer received pemetrexed 500 mg/m(2) and carboplatin AUC = 6 on days 1 and 22 with 5040 centigray of concomitant radiation in 28 fractions over 5.5 weeks followed by esophagectomy as a prelude to a phase II multi-institutional trial.</p><p><strong>Results: </strong>Only 1 of the 6 patients experienced a grade 4 adverse event (neutropenia). This patient also experienced a grade 3 depression. Of the remaining 5 patients, three experienced at least one grade 3 adverse event (neutropenia, nausea/vomiting, and esophagitis). There were no deaths. Incidentally, one patient manifested a complete pathologic response, three a partial pathologic response, and one stable disease.</p><p><strong>Conclusion: </strong>These preliminary observations on safety suggest that this regimen can be further studied in this clinical setting.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"223-5"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s444","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30121215","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":"Late Relapse and Follow-up Protocols in Testicular Germ Cell Tumours: The Edinburgh Cancer Centre Experience and Review of the Literature.","authors":"Beatrice Detti,&nbsp;Paul A Elliott,&nbsp;Duncan B McLaren,&nbsp;Grahame C W Howard","doi":"10.4137/cmo.s321","DOIUrl":"https://doi.org/10.4137/cmo.s321","url":null,"abstract":"<p><strong>Aims: </strong>To identify clinicopathological features and outcomes in patients with late relapse (LR) of testicular germ cell tumours (GCTs) in order to guide follow-up policy.</p><p><strong>Materials and methods: </strong>The Edinburgh Cancer Centre (ECC) database identified all patients diagnosed with testicular GCT between 1988 and 2002. Of 703 patients, six relapsed more than 24 months after their initial treatment. A retrospective casenote review was performed to extract clinical, pathological, treatment and outcome data.</p><p><strong>Results: </strong>Six patients (0.85%) underwent late relapse. All patients presented initially with stage I disease and five were classified as good risk (International Germ Cell Consensus Classification, IGCCC). Median time to LR was 31 months. Two patients had previously relapsed less than 24 months from initial diagnosis. Markers at the time of relapse were normal in all patients. In all cases of late relapse disease was confined to axial lymphadenopathy. Three patients were treated with chemotherapy alone, two patients underwent surgical resection and one patient received combined treatment. All patients obtained a complete response and all remain disease free with a median follow-up of 52 months.</p><p><strong>Conclusions: </strong>The incidence of late relapse in this series is low. Chemo-naive patients with LR were successfully salvaged with chemotherapy alone and patients previously exposed to cisplatin-based chemotherapy were salvaged with complete surgical excision. The optimal length of follow-up in patients with testicular germ cell tumours is not known and practice varies widely. In this cohort of 703 patients, only one patient who relapsed was picked up by additional clinic follow-up between 5 and 10 years. Thus, on the basis of this small series, the authors suggest that follow-up after five years may not be justified.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29974334","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":"Exvivo experiments of human ovarian cancer ascites-derived exosomes presented by dendritic cells derived from umbilical cord blood for immunotherapy treatment.","authors":"Qi-Ling Li,&nbsp;Ning Bu,&nbsp;Yue-Cheng Yu,&nbsp;Wei Hua,&nbsp;Xiao-Yan Xin","doi":"10.4137/cmo.s776","DOIUrl":"https://doi.org/10.4137/cmo.s776","url":null,"abstract":"<p><strong>Objectives: </strong>Exosomes, a type of membrane vesicles, released from tumor cells have been shown to be capable of transferring tumor antigens to dendritic cells and activating specific cytotoxic T-lymphocytes. Recent work has demonstrated the presence of high numbers of exosomes in malignant effusions. Umbilical cord blood (UCB) is a rich source of hematopoietic stem cells and from which a significant number of dendritic cells can be produced. We hypothesized that the exosomes released from metastatic ovarian carcinoma were able to present tumor specific antigen to dendritic cells derived from unrelated umbilical cord blood, then could stimulate resting T cells to differentiate and induce effective cytotoxicity.</p><p><strong>Study design: </strong>Exosomes were isolated by ultracentrifugation of malignant ascites from ovarian cancer patients (n = 10). Purified exosomes were further characterized by Western blot analyses and immunoelectronic microscopy. Dendritic cells were collected from unrelated umbilical cord blood and cultured in the presence of GM-CSF, IL-4 and TNF-α. Resting T cells were mixed with dentritic cells previously primed with exosomes and the cytotoxicity were measured by MTT method. T cells were activated by DCs presented with exosomes.</p><p><strong>Results: </strong>1) the exosomes isolated from the ascites were membrane vesicles of about 30-90nm in diameter; 2) the exosomes expressed MHC class I molecules, HSP70, HSP90, Her2/Neu, and Mart1; and 3)umbilical cord blood-derived DCs previously exosome-primed stimulated resting T cells to differentiate and produce effective cytotoxicity.</p><p><strong>Conclusions: </strong>These results suggested that tumor-specific antigens present on exosomes can be presented by DCs derived from unrelated umbilical cord blood to induce tumor specific cytotoxicity and this may represent as a novel immunotherapy for ovarian cancer.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"461-7"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s776","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30119768","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":"Case report: thymic carcinoma metastatic to small bowel.","authors":"Boris Kobrinsky,&nbsp;Inessa Khaykis,&nbsp;Day Hill,&nbsp;Lydia Petrovic,&nbsp;Herman Yee,&nbsp;Anurag Chandra,&nbsp;David L Diehl","doi":"10.4137/cmo.s824","DOIUrl":"https://doi.org/10.4137/cmo.s824","url":null,"abstract":"","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"477-80"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30119771","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":"Recurrent Respiratory Papillomatosis (RRP)-Juvenile Onset.","authors":"Sara W Dyrstad,&nbsp;Krishna A Rao","doi":"10.4137/cmo.s698","DOIUrl":"https://doi.org/10.4137/cmo.s698","url":null,"abstract":"<p><p>In this article, we describe the treatment of long standing juvenile-onset recurrent respiratory papillomatosis (JORRP) with eventual transformation to carcinoma in a patient who lived to the age of 73. Treatment modalities consisted of bronchoscopy and local excision initially. Later, YAG and CO2 laser debulking were used. Radiotherapy, chemotherapy with carboplatin (300 mg/m2) and 5-FU (600 mg/m2), oral methotrexate (5-7.5 mg/week), pegylated Interferon, indole-3-carbamide, and intralesional cidofovir were also utilized in the treatment of this patient. Except for methotrexate, each of the treatment regimens used in this patient, initially decreased growth of the papillomas and improved symptoms experienced by the patient. Interestingly, we found that this patient's long standing JORRP initially responded to a chemotherapy regimen of 4 cycles of carboplatin (300 mg/m2) and 5-FU (600 mg/m2) as well. Ultimately, the disease became resistant to all forms of treatment and progressed. The patient eventually succumbed to the disease after an approximate 77 year course.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"2 ","pages":"481-6"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30119772","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}