Systemic Treatment Options for Medical Device-Associated Infection

Lupus, Latin for “wolf,” is a term used to describe many dermatologic conditions, some of which are related to underlying systemic lupus erythematosus, while others are distinct disease processes. Cutaneous lupus erythematosus includes a wide array of visible skin manifestations and can progress to systemic lupus erythematosus in some cases. Cutaneous lupus can be subdivided into three main categories: acute cutaneous lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous lupus erythematosus. Physical exam, laboratory studies, and histopathology enable differentiation of cutaneous lupus subtypes. This differentiation is paramount as the subtype of cutaneous lupus informs upon treatment, disease monitoring, and prognostication. This review outlines the different cutaneous manifestations of lupus erythematosus and provides an update on both topical and systemic treatment options for these patients. Other conditions that utilize the term “lupus” but are not cutaneous lupus erythematosus are also discussed.

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Systemic Treatment Options for Advanced-Stage Mycosis Fungoides and Sézary Syndrome

Current Oncology Reports ◽

10.1007/s11912-018-0678-x ◽

2018 ◽

Vol 20 (4) ◽

Cited By ~ 6

Author(s):

Louise Photiou ◽

Carrie van der Weyden ◽

Christopher McCormack ◽

H. Miles Prince

Keyword(s):

Mycosis Fungoides ◽

Systemic Treatment ◽

Treatment Options ◽

Sézary Syndrome ◽

Sezary Syndrome ◽

Advanced Stage

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Tumor Reduction with Pazopanib in a Patient with Recurrent Lumbar Chordoma

Case Reports in Oncological Medicine ◽

10.1155/2018/4290131 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Maurício Fernando Silva Almeida Ribeiro ◽

Micelange Carvalho de Sousa ◽

Samir Abdallah Hanna ◽

Marcos Vinicius Calfat Maldaun ◽

Ceci Obara Kurimori ◽

...

Keyword(s):

Kinase Inhibitors ◽

Systemic Treatment ◽

Treatment Options ◽

Axial Skeleton ◽

Low Grade ◽

Complete Excision ◽

Systemic Treatments ◽

Tumor Reduction ◽

Comprehensive Genomic Profiling ◽

Multifocal Recurrence

Introduction. Chordomas are rare malignancies of bone origin that occur in the axial skeleton, typically the skull base and lumbar/sacral regions. Although often classified as low-grade neoplasms, its locally infiltrative behavior may result in significant morbidity and mortality. Optimal surgical resection may be curative, but up to 50% of the cases relapse within 5 years, and currently there are no systemic treatments approved in this setting. A large proportion of these tumors express stem-cell factor receptor (c-KIT) and platelet-derived growth factor receptors (PDGFRs), providing a rationale for the use of tyrosine-kinase inhibitors (TKIs). Case report. A 27-year-old male presented with recurrent chordoma of the lumbar spine 4 years after initial diagnosis. Salvage therapies in the interval included repeat resections and radiation therapy. He ultimately developed multifocal recurrence not amenable to complete excision or reirradiation. A comprehensive genomic profiling assay was performed and revealed nondrugable alterations. Decision was made to proceed with systemic treatment with pazopanib 800 mg/day, resulting in tumor reduction (−23.1% reduction in size) and prolonged disease control. Conclusion. For this patient with a multiple recurrent chordoma and limited treatment options, pazopanib resulted in sustained clinical benefit following initial tumor reduction.

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Sexual Health in Menopause

Medicina ◽

10.3390/medicina55090559 ◽

2019 ◽

Vol 55 (9) ◽

pp. 559 ◽

Cited By ~ 2

Author(s):

Scavello ◽

Maseroli ◽

Di Stasi ◽

Vignozzi

Keyword(s):

Sex Steroids ◽

Systemic Treatment ◽

Treatment Options ◽

Therapeutic Strategies ◽

First Line ◽

Genitourinary Syndrome Of Menopause ◽

Cardiovascular Comorbidities ◽

Low Sexual Desire ◽

Modifiable Factors ◽

Genitourinary Syndrome

Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40–55%), poor lubrication (25–30%) and dyspareunia (12–45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.

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Systemic Treatment for Advanced and Metastatic Malignant Peripheral Nerve Sheath Tumors—A Sarcoma Reference Center Experience

Journal of Clinical Medicine ◽

10.3390/jcm9103157 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3157

Author(s):

Paweł Sobczuk ◽

Paweł Teterycz ◽

Anna M. Czarnecka ◽

Tomasz Świtaj ◽

Hanna Koseła-Paterczyk ◽

...

Keyword(s):

Peripheral Nerve ◽

Systemic Treatment ◽

Treatment Options ◽

Soft Tissue Sarcomas ◽

Nerve Sheath Tumor ◽

First Line ◽

Rare Type ◽

Reference Center ◽

Peripheral Nerve Sheath Tumors ◽

Nerve Sheath

Malignant peripheral nerve sheath tumor (MPNST) is a rare type of soft tissue sarcomas. The localized disease is usually treated with surgery along with perioperative chemo- or radiotherapy. However, up to 70% of patients can develop distant metastases. The study aimed to evaluate the modes and outcomes of systemic treatment of patients with diagnosed MPNST treated in a reference center. In total, 115 patients (56 female and 59 male) diagnosed with MPNST and treated due to unresectable or metastatic disease during 2000–2019 were included in the retrospective analysis. Schemes of systemic therapy and the outcomes—progression-free survival (PFS) and overall survival (OS)—were evaluated. The median PFS in the first line was 3.9 months (95% CI 2.5–5.4). Doxorubicin-based regimens were the most commonly used in the first line (50.4% of patients). There were no significant differences in PFS between chemotherapy regimens most commonly used in the first line (p = 0.111). The median OS was 15.0 months (95% CI 11.0–19.0) and the one-year OS rate was 63%. MPNST are resistant to the majority of systemic therapies, resulting in poor survival in advanced settings. Chemotherapy with doxorubicin and ifosfamide is associated with the best response and longest PFS. Future studies and the development of novel treatment options are necessary for the improvement of treatment outcomes.

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Pharmacological treatment of hepatocellular carcinoma with cavoatrial tumor thrombus – case series and literature review

Zeitschrift für Gastroenterologie ◽

10.1055/a-0855-4469 ◽

2019 ◽

Vol 57 (04) ◽

pp. 501-507 ◽

Cited By ~ 4

Author(s):

Tianzuo Zhan ◽

Janina Sollors ◽

Niels Steinebrunner ◽

Hans Schlitt ◽

Christian Stroszczynski ◽

...

Keyword(s):

Tumor Thrombus ◽

Systemic Treatment ◽

Treatment Options ◽

Survival Rates ◽

Vena Cava ◽

Case Series ◽

Surgical Approaches ◽

Surgical Interventions ◽

Advanced Hcc ◽

Multimodal Therapy Concept

AbstractHepatocellular carcinomas (HCC) that extend into the vena cava and the right atrium have a poor prognosis. Surgical approaches including partial hepatectomy and thrombectomy are the most frequently reported treatment options. However, most patients with advanced HCC are not eligible for complex surgical interventions due to reduced liver function, comorbidities, and metastases. At the same time, systemic treatment options of HCC have expanded in recent years. Here, we report 3 cases of patients with advanced HCC who developed a cavoatrial tumor thrombus (CATT) after initial surgical or interventional therapy. The patients were consequently treated with sorafenib or nivolumab. In all cases, the tumor responded to systemic treatment with disease stabilization or partial regression. Overall survival after diagnosis of CATT was 3 and 17 months for sorafenib and 7 + months for nivolumab. Compared to survival rates of alternative treatment options, systemic therapies demonstrated comparable outcomes. In summary, pharmacotherapy is an efficient and well worth option to treat patients with HCC and CATT and should be an integral part of a multimodal therapy concept.

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Systemic Treatment Options for HER2-Positive Breast Cancer Patients with Brain Metastases beyond Trastuzumab: A Literature Review

Breast Care ◽

10.1159/000467387 ◽

2017 ◽

Vol 12 (3) ◽

pp. 168-171 ◽

Cited By ~ 12

Author(s):

Elena Laakmann ◽

Volkmar Müller ◽

Marcus Schmidt ◽

Isabell Witzel

Keyword(s):

Breast Cancer ◽

Brain Metastases ◽

Cancer Patients ◽

Systemic Treatment ◽

Treatment Options ◽

Cytotoxic Agents ◽

Breast Cancer Patients ◽

Her2 Positive ◽

Her2 Positive Breast Cancer ◽

Positive Breast Cancer

Background: The incidence of brain metastases (BM) in breast cancer patients has increased. Many retrospective analyses have shown that first-line treatment with trastuzumab prolongs survival in patients with HER2-positive BM. In contrast, the evidence for other therapies targeting HER2 for patients with BM is rare. Methods: The aim of this review is to update the reader about current systemic treatment options in patients with HER2-positive metastatic breast cancer with BM who had already received trastuzumab. A literature search was performed in the PubMed database in June 2016. 30 relevant reports concerning the efficacy of trastuzumab emtansine (T-DM1), lapatinib and its combination with other cytotoxic agents, pertuzumab and novel HER2-targeting substances were identified. Results: There is limited but promising evidence for the use of T-DM1 and pertuzumab in the treatment of BM. Up to now, most reported studies used lapatinib as treatment of HER2-positive breast cancer with BM, a treatment with only a modest effect and a high toxicity profile. The combination of lapatinib with cytotoxic agents seems to result in better response rates. Conclusion: Further prospective investigations are needed to investigate the efficacy of the established and novel HER2-targeting agents on BM in HER2-positive breast cancer patients.

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Systemic treatment options for metastatic hormone-sensitive prostate cancer

Current Opinion in Urology ◽

10.1097/mou.0000000000000778 ◽

2020 ◽

Vol 30 (4) ◽

pp. 576-583 ◽

Cited By ~ 1

Author(s):

Catalin Baston ◽

Adrian Preda ◽

Silviu S. Guler-Margaritis ◽

Ioanel Sinescu ◽

Constantin Gingu

Keyword(s):

Prostate Cancer ◽

Systemic Treatment ◽

Treatment Options ◽

Hormone Sensitive

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Lymphoepithelioma-like carcinoma of the urinary bladder: A case report and review of systemic treatment options

Urology Annals ◽

10.4103/0974-7796.91626 ◽

2012 ◽

Vol 4 (1) ◽

pp. 45 ◽

Cited By ~ 11

Author(s):

NicholasM Pantelides ◽

StellaL Ivaz ◽

Alison Falconer ◽

Steven Hazell ◽

Mathias Winkler ◽

...

Keyword(s):

Case Report ◽

Urinary Bladder ◽

Systemic Treatment ◽

Treatment Options

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A phase II trial of MEK inhibitor BAY 86-9766 in combination with sorafenib as first-line systemic treatment for patients with unresectable hepatocellular carcinoma (HCC).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.4103 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 4103-4103 ◽

Cited By ~ 5

Author(s):

Ho Yeong Lim ◽

Chia-Jui Yen ◽

Won-Young Tak ◽

Jeong Heo ◽

Hye Jin Choi ◽

...

Keyword(s):

Survival Data ◽

Systemic Treatment ◽

Performance Status ◽

Treatment Options ◽

Tumor Lysis Syndrome ◽

Mek Inhibitor ◽

Open Label ◽

Treatment Safety ◽

Almost All ◽

Dose Modifications

4103 Background: Sorafenib (S) is the only approved systemic treatment for unresectable HCC. Nevertheless, there remains an unmet medical need for more effective treatment options for this disease. BAY 86-9766 (B) is an oral, allosteric inhibitor of MEK, a key component of the MAP kinase pathway. This study evaluated the efficacy and safety of a combination therapy with B plus S in patients (pts) with HCC. Methods: This is a single arm, open-label, phase 2 study. Eligible were pts with unresectable HCC, Child-Pugh Class A, performance status (PS) 0-1, and no prior systemic anticancer therapy for HCC. Pts started Cycle 1 (21 days) with B 50 mg bid orally plus S 600 mg daily (200 mg AM, 400 mg PM) orally. If there was no hand-foot skin reaction, fatigue, or gastrointestinal toxicity ≥ grade 2, S was escalated to 400 mg bid from Cycle 2 on. Treatment continued until progression or withdrawal criteria were met. Tumor assessment was performed every 6 weeks during treatment. Safety was evaluated every week for the first 6 weeks and every 3 weeks thereafter. Results: Seventy pts from Asia started study treatment. Pts were predominantly male (86%); median age was 56 years; 54% had PS of 0 and 46% PS of 1. The vast majority had liver cirrhosis (83%) and infection with HBV (76%) or HCV (17%). Sixty-five were evaluable for efficacy per protocol. Three pts (5%) had confirmed partial response and 25 pts (38%) had prolonged stable disease (≥10 weeks), with a disease control rate of 43%. Median time-to-progression was 4.1 months. Survival data are not mature, yet. The most frequent drug-related adverse events (AEs) were rash (60%), diarrhea (59%), AST elevation (43%), vomiting (30%), nausea (29%), ALT elevation (26%), and anorexia (26%). There were 4 Grade 5 related AEs (hepatic failure, sepsis/hepatic encephalopathy, tumor lysis syndrome, and unknown cause, respectively). Dose modifications due to AEs were necessary in almost all pts. The median daily dose was 64.2 mg for B and 443.3 mg for S, respectively. Conclusions: B in combination with S showed antitumor activity in pts with HCC. However, frequent dose modifications due to AEs might have limited the treatment effect of this combination.

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