American journal of clinical oncology
-
Am. J. Clin. Oncol. · Oct 2015
Controlled Clinical TrialClinical and Genetic Factors Associated With Severe Hematological Toxicity in Glioblastoma Patients During Radiation Plus Temozolomide Treatment: A Prospective Study.
Temozolomide (TMZ) administered daily with radiation therapy (RT) for 6 weeks, followed by adjuvant TMZ for 6 cycles, is the standard therapy for newly diagnosed glioblastoma (GBM) patients. Although TMZ is considered to be a safe drug, it has been demonstrated to cause severe myelotoxicity; in particular, some case reports and small series studies have reported severe myelotoxicity developing during TMZ and concomitant RT. We performed a prospective study to analyze the incidence of early severe myelotoxicity and its possible clinical and genetic factors. ⋯ Although we studied a small population, we suggest that both clinical and genetic factors might simultaneously be associated with severe myelosuppression developed during TMZ plus RT. However, our results deserve validation in larger prospective studies and, if the factors associated with severe myelotoxicity are validated, dose adjustments of TMZ for those patients may reduce the risk of severe myelotoxicity during the concomitant treatment.
-
Am. J. Clin. Oncol. · Aug 2015
ReviewEmerging immunotherapies in the treatment of non-small cell lung cancer (NSCLC): the role of immune checkpoint inhibitors.
Immune checkpoint inhibition as a new treatment approach is undergoing extensive investigation in non-small cell lung cancer (NSCLC) and other malignancies. Unlike standard chemotherapy or targeted agents, which act directly on the tumor cells, immune checkpoint inhibitors work by restoring the immune system's capacity to eradicate tumors. ⋯ This article reviews the immune checkpoint inhibitors and the available data to date on their use in lung cancer. Clinical implications for the use of these therapies in NSCLC are discussed as they relate to their novel mechanisms of action, response patterns, and safety profiles.
-
Am. J. Clin. Oncol. · Aug 2015
Dosimetric definitions of total lung volumes in calculating parameters predictive for radiation-induced pneumonitis.
The volume of normal lung receiving 20 Gy (V20) and the mean lung dose (MLD) represent dosimetric parameters used for identifying risk of radiation pneumonitis. However, the total lung volume for dosimetric analysis has been defined differently. Herein we investigate to quantify the dosimetric differences when analysis is based on either definition (ie, excluding planning target volume [PTV] vs. gross tumor volume [GTV] from the total bilateral lung volume). ⋯ A small but significant difference exists between the 2 approaches used to calculate dosimetric variables for lung dose. This difference should be taken into account when comparing dosimetric information between different institutions and when optimizing treatment plans.
-
Am. J. Clin. Oncol. · Aug 2015
Predictors of locoregional outcome in HER2-overexpressing breast cancer treated with neoadjuvant chemotherapy.
We identified prognostic factors for locoregional recurrence (LRR) in a cohort of patients with HER2-overexpressing breast cancer treated with neoadjuvant chemotherapy (NACT). ⋯ In a cohort with stage II to III HER2-overexpressing breast cancer treated predominantly with trastuzumab-containing NACT followed by mastectomy±RT, we identified omission of RT, negative ER status, and residual positive lymph nodes as significant predictors of LRR, with 50% of LRR having a regional component.
-
Am. J. Clin. Oncol. · Jun 2015
Outcomes After Multidisciplinary Treatment of Inflammatory Breast Cancer in the Era of Neoadjuvant HER2-directed Therapy.
We previously reported survival trends among patients with inflammatory breast cancer (IBC) over a 30-year period before 2005. Here we evaluated survival outcomes for women with IBC diagnosed before or after October 2006, in the era of HER2-directed therapy and after opening a dedicated multidisciplinary IBC clinic. ⋯ Survival improved in the context of the IBC clinic and prompt initiation of neoadjuvant HER2-directed therapeutics.