Asia-Pacific journal of clinical oncology
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Asia Pac J Clin Oncol · Oct 2019
Case ReportsOsimertinib 160 mg daily for advanced non-small cell lung cancer with leptomeningeal metastasis: A case report.
Advanced non-small cell lung cancer (NSCLC) with leptomeningeal metastases (LM) is associated with a dismal prognosis of typically 3-9 months. In preclinical and clinical studies, the third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor osimertinib has demonstrated activity in the central nervous system (CNS), and studies are ongoing. We report here a case of osimertinib used at 160 mg once daily in a heavily pretreated patient with EGFR exon 20 T790M-negative advanced NSCLC with LM to achieve a partial response, including shrinkage of the LM, for up to 12 months until further progression. The case suggests the feasibility of using osimertinib at a twofold standard dose to treat CNS metastases, irrespective of the T790M mutation status.
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Asia Pac J Clin Oncol · Feb 2019
Multicenter Study Comparative Study Observational StudyLongitudinal validation and comparison of the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life-Chemotherapy-Induced Peripheral Neuropathy Questionnaire (EORTC QLQ-CIPN20) and the Functional Assessment of Cancer-Gynecologic Oncology Group-Neurotoxicity subscale (FACT/GOG-Ntx).
To validate and compare the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life-Chemotherapy-Induced Peripheral Neuropathy Questionnaire (EORTC QLQ-CIPN20) and the Functional Assessment of Cancer-Gynecologic Oncology Group-Neurotoxicity subscale (FACT/GOG-Ntx) for measuring chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients. ⋯ The Chinese version of the EORTC QLQ-CIPN20 and FACT/GOG-Ntx demonstrated acceptable reliability, validity and responsiveness and was found comparable in measuring CIPN among Chinese cancer patients at specific assessment points.
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Asia Pac J Clin Oncol · Feb 2019
Real-world efficacy and toxicity of combined nivolumab and ipilimumab in patients with metastatic melanoma.
There is limited real-world data on the efficacy and safety of combination programmed cell death protein-1 (PD-1) inhibitor, nivolumab and the cytotoxic T-lymphocyte antigen (CTLA-4) inhibitor ipilimumab. ⋯ In this study, responses to combination immunotherapy were lower than reported. Patients treated with prior immunotherapy had similar responses as treatment-naïve pts. The toxicity profile seen in this study is similar to those reported in clinical trials.
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Asia Pac J Clin Oncol · Dec 2018
ReviewRe-inventing the randomized controlled trial in medical oncology: The registry-based trial.
Substantial progress has recently been made in optimizing the management of cancer patients, resulting in major gains in survival and quality of life. Much of this progress has resulted from the serial testing of promising treatment strategies, typically using prospective randomized controlled trials to compare outcomes achieved with the new approach versus the current standard(s) of care. However, there is an ever-expanding list of important questions that are difficult to investigate, particularly with respect to determining the optimal sequencing and combination of proven active agents. ⋯ These questions can be investigated in the context of registry-based randomized clinical trials. Recently, the potential of registry-based randomized clinical trials was demonstrated in cardiology, highlighting the ability to rapidly recruit large numbers of patients to a trial addressing an important clinical question, with minimal cost and high external validity. In this review, we discuss the challenges and limitations of conventional clinical trials in multidisciplinary cancer care, describe the potential advantages of registry-based randomized trials, and highlight several registry-based oncology studies that are already underway to demonstrate the feasibility of this approach.
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Asia Pac J Clin Oncol · Oct 2018
Observational StudyEnd-of-life care of oncology inpatients: Are we getting it right?
To examine the current patterns of end-of-life care of medical oncology patients dying in an Australian tertiary acute hospital setting in order to determine potential areas for improvement. ⋯ There was a high level of documented resuscitation plans, comfort care plans and recognition of dying. However, active interventions were common within 48 h of death, and comfort care plans and recognition of dying often occurred late. These data indicate a gap between documenting a resuscitation plan and providing timely and appropriate end-of-life care. Understanding the gaps in delivering appropriate care provides an opportunity for improving end-of-life care.