Estimating tumor response rates using shrinkage estimates

2004 ◽  
Vol 75 (2) ◽  
pp. P43
Author(s):  
S Kathman
Keyword(s):  
Tumor Response ◽  
Response Rates

In Vitro Tumor Response Rates and Population Treatment Response Rates for Non–Small-Cell Lung Cancer

2009 ◽  
Vol 10 (5) ◽  
pp. E13
Author(s):  
Rodney J. Landreneau ◽  
Robert J. Cerfolio ◽  
Robert J. McKenna ◽  
Matthew J. Schuchert ◽  
Daniel L. Miller ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Treatment Response ◽  
Cell Lung Cancer ◽  
Tumor Response ◽  
Response Rates ◽  
Small Cell ◽  
Small Cell Lung ◽  
Population Treatment

Primary CNS Lymphoma

2006 ◽  
Vol 24 (8) ◽  
pp. 1281-1288 ◽  
Author(s):  
Tracy Batchelor ◽  
Jay S. Loeffler
Keyword(s):  
Tumor Response ◽  
Negative Impact ◽  
Systemic Disease ◽  
Primary Cns Lymphoma ◽  
Response Rates ◽  
Therapeutic Benefit ◽  
Tumor Control ◽  
Cns Lymphoma ◽  
Imaging Features ◽  
Whole Brain Radiation

Primary CNS lymphoma (PCNSL), an uncommon form of extranodal non-Hodgkin's lymphoma (NHL), has increased in incidence during the last three decades and occurs in both immunocompromised and immunocompetent hosts. PCNSL in immunocompetent patients is associated with unique diagnostic, prognostic, and therapeutic issues, and the management of this malignancy is different from that of other forms of extranodal NHL. Characteristic imaging features should be suggestive of the diagnosis, avoidance of corticosteroids, if possible, and early neurosurgical consultation for stereotactic biopsy. Because PCNSL may involve the brain, CSF, and eyes, diagnostic evaluation should include assessment of all of these regions as well as screening for possible occult systemic disease. Resection provides no therapeutic benefit and should be reserved for the rare patient with neurologic deterioration due to brain herniation. Whole-brain radiation therapy (WBRT) alone is insufficient for durable tumor control and is associated with a high risk of neurotoxicity in patients older than age 60. Neurotoxicity typically is associated with significant cognitive, motor, and autonomic dysfunction, and has a negative impact on quality of life. Chemotherapy and WBRT together improve tumor response rates and survival compared with WBRT alone. Methotrexate-based multiagent chemotherapy without WBRT is associated with similar tumor response rates and survival compared with regimens that include WBRT, although controlled trials have not been performed. The risk of neurotoxicity is lower in patients treated with chemotherapy alone.

scholarly journals Tyrosinase Overexpression Promotes ATM-Dependent p53 Phosphorylation by Quercetin and Sensitizes Melanoma Cells to Dacarbazine

2008 ◽  
Vol 30 (5) ◽  
pp. 371-387
Author(s):  
Thilakavathy Thangasamy ◽  
Sivanandane Sittadjody ◽  
Kirsten H. Limesand ◽  
Randy Burd
Keyword(s):  
Low Dose ◽  
Tumor Response ◽  
Chemotherapeutic Agent ◽  
Response Rates ◽  
Melanoma Cells ◽  
High Dose ◽  
Ataxia Telangiectasia Mutated ◽  
Damage Response ◽  
Targeted Agent ◽  
Mutant Cells

Dacarbazine (DTIC) has been used for the treatment of melanoma for decades. However, monotherapy with this chemotherapeutic agent results only in moderate response rates. To improve tumor response to DTIC current clinical trials in melanoma focus on combining a novel targeted agent with chemotherapy. Here, we demonstrate that tyrosinase which is commonly overexpressed in melanoma activates the bioflavonoid quercetin (Qct) and promotes an ataxia telangiectasia mutated (ATM)-dependent DNA damage response. This response sensitizes melanoma cells that overexpress tyrosinase to DTIC. In DB-1 melanoma cells that overexpress tyrosinase (Tyr+ cells), the threshold for phosphorylation of ATM and p53 at serine 15 was observed at a low dose of Qct (25 μM) when compared to the mock transfected pcDNA3 cells, which required a higher dose (75 μM). Both pcDNA3 and Tyr+ DB-1 cells demonstrated similar increases in phosphorylation of p53 at other serine sites, but in the Tyr+ cells, DNApk expression was found to be reduced compared to control cells, indicating a shift towards an ATM-mediated response. The DB-1 control cells were resistant to DTIC, but were sensitized to apoptosis with high dose Qct, while Tyr+ cells were sensitized to DTIC with low or high dose Qct. Qct also sensitized SK Mel 5 (p53 wildtype) and 28 (p53 mutant) cells to DTIC. However, when SK Mel 5 cells were transiently transfected with tyrosinase and treated with Qct plus DTIC, SK Mel 5 cells demonstrated a more than additive induction of apoptosis. Therefore, this study demonstrates that tyrosinase overexpression promotes an ATM-dependent p53 phosphorylation by Qct treatment and sensitizes melanoma cells to dacarbazine. In conclusion, these results suggest that Qct or Qct analogues may significantly improve DTIC response rates in tumors that express tyrosinase.

The Use of Gallium-67 Scintigraphy to Monitor Tumor Response Rates and Predict Long-Term Clinical Outcome in Patients with Lymphoma

2004 ◽  
Vol 5 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Mahmoud M. Tuli ◽  
Salem H. Al-Shemmari ◽  
Reem M. Ameen ◽  
Shihab Al-Muhanadi ◽  
Fawaz Abu Al-Huda ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Tumor Response ◽  
Response Rates ◽  
Gallium 67

Hepatic arterial infusion (HAI) compared to systemic chemotherapy for the treatment of unresectable liver metastases from colorectal carcinoma: A systematic review and meta-analysis of randomized controlled trials

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14519-14519
Author(s):  
S. Mocellin ◽  
P. Pilati ◽  
M. Lise ◽  
D. Nitti
Keyword(s):  
Randomized Controlled Trials ◽  
Anticancer Agents ◽  
Systemic Chemotherapy ◽  
Tumor Response ◽  
Cox Model ◽  
Meta Analysis ◽  
Response Rates ◽  
P Value ◽  
Controlled Trials ◽  
Randomized Controlled

14519 Background: The treatment of unresectable liver confined metastatic disease from colorectal cancer is a challenging issue. Although locoregional treatments such as HAI claim the advantage of delivering higher doses of anticancer agents directly into the affected organ, the evidence for benefit in terms of overall survival (OS) is conflicting. We aimed to quantitatively summarize the results so far described in randomized trials comparing HAI to systemic chemotherapy. Methods: To date, ten randomized controlled trials (RCT) have been published, for a total of 1,277 patients enrolled. Seven RCT (n=1,098) enrolling at least 50 patients per arm (the minimum sample size required to achieve a type II error lower than 20%) were considered for OS meta-analysis, which was based on the inverse of variance method. For tumor response rates, hazard ratios (HR) and their 95% confidence intervals (CI) were obtained from raw data; for OS, HR and CI were obtained from reported Cox model survival analyses or were calculated from Kaplan-Meier survival curves according to the Parmar method. Results: HAI regimens were based on floxuridine (FUDR) in nine out of ten RCT, while in one case 5-fluorouracil (5FU) + leucovorin (LV) were used. Systemic chemotherapy consisted of FUDR, 5FU, 5FU + LV, or a miscellany of 5FU and best supportive care in three, one, four and two studies, respectively. Tumor response and median OS were better in the HAI arm in eight and three RCT, respectively. At meta-analysis, median tumor response rate was 38.84% and 17.30% for HAI and systemic chemotherapy, respectively (HR: 2.24, CI: 1.80- 2.81; P < 0.0001); on average, median OS was 16.04 and 12.64 months, respectively (HR: 0.83, CI: 0.58–1.19; P value 0.30). Conclusions: Although HAI regimens are followed by significantly higher tumor response rates, no OS advantage can be demonstrated for this locoregional treatment as compared to systemic chemotherapy. Since HAI has been so far compared to systemic chemotherapy regimens not containing modern and more effective antineoplastic agents (e.g. oxaliplatin, irinotecan), these findings do not support the clinical or investigational use of FUDR-based HAI. No significant financial relationships to disclose.

inSIRT trial: Single-center phase II study of yttrium-90 radioactive resin microspheres in the treatment of liver-predominant metastatic colorectal adenocarcinoma after failure of first-line combination chemotherapy.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 685-685
Author(s):  
Eric Roeland ◽  
Kelly Anne Shimabukuro ◽  
Paul Timothy Fanta ◽  
Steven C. Rose ◽  
Tony R. Reid
Keyword(s):  
Liver Metastases ◽  
Phase Ii ◽  
Combination Chemotherapy ◽  
Tumor Response ◽  
Phase Ii Study ◽  
Hepatic Metastases ◽  
Response Rates ◽  
Second Line ◽  
First Line ◽  
Yttrium 90

685 Background: Liver metastases develop in half of colorectal cancer (CRC) cases and once metastatic ~90% die due to consequences from the hepatic metastases. We are evaluating the aggressive management of liver metastases through the incorporation of selective internal radiation therapy (SIRT) using yttrium-90 radioactive microspheres after evidence of progressive disease following first-line FOLFOX ± bevacizumab. Optimal timing for microsphere treatment relative to chemotherapy is not clearly established. We present preliminary data of a phase II study evaluating tumor response rates to SIRT following FOLFOX ± bevacizumab and prior to FOLFIRI. Methods: Subjects with predominant hepatic metastatic CRC despite first-line FOLFOX based therapy ± bevacizumab are eligible. Interventional radiology and nuclear medicine assess the liver lesions and the subject receives SIRT followed by second-line FOLFIRI (without bevacizumab) 4-6 weeks after the final SIRT. The primary objective is PFS at 6 mos and secondary objectives include: OS, tumor response rates, and toxicity. Results: To date, 8 metastatic CRC subjects have been treated and 9 subjects enrolled (goal 30 subjects). One subject was withdrawn due to progressive lung metastases. 4 of 8 subjects (50%) achieved PFS at 6 mos and average TTP is 6.7 mos (0.7-17.3 mos). Overall treatment has been well tolerated, but one possible study related SAE of liver failure occurred (subject 8). The OS endpoint has not been achieved. Conclusions: Historically, second-line FOLFIRI has achieved a 2.5 mos median PFS. In 8 subjects with liver predominant metastatic CRC, we have observed 50% PFS at 6 mos. These encouraging results demonstrate the utility of an innovative direct approach to metastatic CRC after failure of first-line combination chemotherapy. [Table: see text]

Radiochemotherapy for lung cancer with cisplatin and vinorelbine orally and shrinking field radiotherapy: Effectivity and feasibility in a nonselected patient collective.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17516-e17516
Author(s):  
Miriam Zagel ◽  
Anja Tobermann ◽  
Ludwig Fischer von Weikersthal ◽  
Antje Fahrig
Keyword(s):  
Side Effects ◽  
Tumor Response ◽  
No Reduction ◽  
Response Rates ◽  
Hematologic Toxicity ◽  
Median Dose ◽  
Stage Iiia ◽  
Adequate Dose ◽  
Simultaneous Radiochemotherapy ◽  
Acceptable Side

e17516 Background: To explore the side effects and effectivity of simultaneous radiochemotherapy (sim RCT) with cisplatin (Cis-DDP) and vinorelbine orally (VRBo) in pts. with NSCLC. Methods: From 2009 and 2011, a total of 20 pts. (5 female, 15 male) aged between 46 and 82 yrs. with NSCLC stage IIIA/B were irradiated with a median dose of 66.6 Gy to the primary and 45 Gy to the involved nodes as neoadjuvant or palliative treatment. Treatment volumes were adapted to tumor shrinkage after 19.8, 30.6, 45 and 59.4 Gy. Cis-DDP (20 mg/qm d1-4, d29-32) and VRBo (50 mg/qm d1,8,15,22,36,43) were administered simultaneously. Comorbidity was scored by the Charlson Index and nutritional status was monitored. Results: Toxicity rates: thrombopenia 3° 10%, 4° 0%, leucopenia 3° 15%, 4° 20%, haemoglobin 0% 3°/4°, esophagitis 3° 5%, 4° 0%, pneumonitis 3° 0%, 4° 5%. No reduction of planned RT-dose. Chx reduction was done due to hematologic toxicity in 35%. Response rates: CR 10%, PR 75%, SD 10%, PD 5%. 11pts. (55%) are alive after a median FU of 19 months. Conclusions: Sim RCT with Cis-DDP and VRBo results in good tumor response rates and is feasible with acceptable side effects. Shrinking treatment volumes allow adequate dose escalation without the risk for early locoregional recurrence.

The Effect on Tumor Response of Adding Sequential Preoperative Docetaxel to Preoperative Doxorubicin and Cyclophosphamide: Preliminary Results From National Surgical Adjuvant Breast and Bowel Project Protocol B-27

2003 ◽  
Vol 21 (22) ◽  
pp. 4165-4174 ◽  
Author(s):  
Harry D. Bear ◽  
Stewart Anderson ◽  
Ann Brown ◽  
Roy Smith ◽  
Eleftherios P. Mamounas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Response ◽  
Response Rate ◽  
Complete Response Rate ◽  
Response Rates ◽  
Complete Response ◽  
Operable Breast Cancer ◽  
National Surgical Adjuvant Breast ◽  
Surgery Group ◽  
Bowel Project

Purpose: The National Surgical Adjuvant Breast and Bowel Project Protocol B-27 was designed to determine the effect of adding docetaxel after four cycles of preoperative doxorubicin and cyclophosphamide (AC) on clinical and pathological response rates and on disease-free and overall survival of women with operable breast cancer. Patients and Methods: Women (N = 2,411) with operable primary breast cancer were randomly assigned to receive either four cycles of preoperative AC followed by surgery (group I), or four cycles of AC followed by four cycles of docetaxel, followed by surgery (group II), or four cycles of AC followed by surgery and then four cycles of docetaxel (group III). Clinical and pathologic tumor responses to preoperative therapy were assessed. Results: Mean tumor size (4.5 cm) and other key characteristics were evenly balanced among the three treatment arms. Grade 4 toxicity was observed in 10.3% of 2,400 patients during AC treatment, and in 23.4% of 1584 patients during docetaxel treatment. Compared to preoperative AC alone, preoperative AC followed by docetaxel increased the clinical complete response rate (40.1% v 63.6%; P < .001), the overall clinical response rate (85.5% v 90.7%; P < .001), the pathologic complete response rate (13.7% v 26.1%; P < .001), and the proportion of patients with negative nodes (50.8% v 58.2%; P < .001). Pathologic primary breast tumor response was a significant predictor of pathologic nodal status (P < .001). Conclusion: The addition of four cycles of preoperative docetaxel after four cycles of preoperative AC significantly increased clinical and pathologic response rates for operable breast cancer.

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