Karnofsky Memorial Lecture. Breaking the cure barrier.

1983 ◽  
Vol 1 (2) ◽  
pp. 75-90 ◽  
Author(s):  
J F Holland

Breaking the cure barrier is a biologic and a conceptual problem that has already been accomplished for several tumors. It is helpful to consider neoplasms in mathematical terms as many-celled tumors (polycytomas: kilocytomas, megacytomas, gigacytomas, and teracytomas). A new chemotherapeutic taxonomy recognizes curable, subcurable, and precurable cancers each with definable characteristics. A simplified technique of recognizing early cures is described by calculating the probability that an interruption in an exponential failure slope occurred by chance. Examples of cures of acute myelocytic leukemia, of superior chemotherapy for Hodgkin's disease in young adults, and of superior adjuvant chemotherapy for breast cancer are given. The interaction of surgery with chemotherapy is illustrated in pure form in acute myelocytic leukemia and in ovarian cancer. Curative chemotherapy is closer at hand than is generally believed. Nomograms for cure prediction are presented as inducements to contemplate curative approaches to cancer therapy.

1992 ◽  
Vol 78 (5) ◽  
pp. 356-358 ◽  
Author(s):  
Luigi Cavanna ◽  
Daniele Vallisa ◽  
Michele Di Stasi ◽  
Fabio Fornari ◽  
Elisabetta Buscarini ◽  
...  

This report describes 2 patients who developed acute myelocytic leukemie (AML) type M2 and chronic myelomonocytic leukemia (CMML) of the FAB classification, respectively 2 months and 2 weeks after diagnosis of operable breast cancer. The patient with AML showed pancytopenia 2 months before the diagnosis of AML, had a normal karyotype, and showed a good response to chemotherapy. The patient with CMML had a normal karyotype, and she was treated with hydroxyurea and supportive therapy. The 2 patients had no previous exposure to irradiation or cytotoxic therapy. These cases show that breast cancer and either leukemia or myelodysplastic syndrome may be associated even without previous irradiation or combination chemotherapy.


2018 ◽  
Vol 26 ◽  
pp. e17948
Author(s):  
Laís De Andrade Martins Cordeiro ◽  
Denismar Alves Nogueira ◽  
Clícia Valim Côrtes Gradim

Objetivo: avaliar a qualidade de vida de mulheres com neoplasia mamária e em quimioterapia adjuvante. Método: estudo descritivo, transversal e quantitativo desenvolvido com 25 mulheres em tratamento em uma Unidade de Assistência de Alta Complexidade em Oncologia de uma cidade do Brasil, por meio do questionário Functional Assessment of Cancer Therapy – Breast plus Arm Morbidity (FACTB +4). Pesquisa aprovada no Comitê de Ética em Pesquisa da Universidade Federal de Alfenas (UNIFAL-MG), por meio do Protocolo: 208/2011. Resultados: verificaram- se, em âmbito geral, bons resultados de qualidade de vida nos domínios e para o FACT B Total. Encontraram-se menores médias de escores nos domínios preocupações adicionais com o câncer de mama (22,68±4,96/36) e bem-estar funcional (16,92±4,60/28). Conclusão: destaca-se a necessidade de cuidados referentes às modificações da imagem corporal, ao estresse sobre a doença e anseios de um familiar vir a ter câncer.ABSTRACTObjective: to evaluate the quality of life of women with breast cancer in adjuvant chemotherapy. Method: this descriptive, quantitative, cross-sectional study examined 25 women undergoing treatment at a High Complexity Oncology Unit in a Brazilian city, in 2012, using the Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACT B +4) questionnaire. The study was approved by the research ethics committee of Alfenas Federal University (UNIFAL-MG), under Protocol 208/2011. Results: by and large, good quality of life was found in the domains and for Total FACT B. Lower mean scores were observed in the additional concerns with breast cancer (22.68 ± 4.96/36) and functional well-being (16.92 ± 4.60/28) domains. Conclusion: the findings highlighted the need for care relating to changes in body image, disease-related stress and anxiety that a family member may come to have cancer.RESUMENObjetivo: evaluar la calidad de vida de mujeres con neoplasia mamaria y en quimioterapia adyuvante. Método: estudio descriptivo, transversal y cuantitativo desarrollado junto a 25 mujeres en tratamiento en una Unidad de Asistencia de Alta Complejidad en Oncología de una ciudad de Brasil, en 2012; por medio del cuestionario Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACTB +4). Investigación aprobada en el Comité de Ética en Investigación de la Universidad Federal de Alfenas (UNIFAL-MG), a través del Protocolo: 208/2011. Resultados: se verificaron, en general, buenos resultados de calidad de vida en los dominios y para el FACT B Total. Se encontraron menores promedios de escores en los dominios ‘preocupaciones adicionales con el cáncer de mama (22,68/36) y bienestar funcional (16,92/28)’. Conclusión: se destaca la necesidad de cuidados referentes a las modificaciones de la imagen corporal, al estrés sobre la enfermedad y preocupaciones con la posibilidad de que un familiar vaya a tener cáncer.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e18538-e18538
Author(s):  
Dennis A. Wigle ◽  
Allan Hallquist ◽  
Cary Presant ◽  
Julian R. Molina

e18538 Background: The drug-induced apoptosis MiCK assay has been predictive of outcomes in acute myelocytic leukemia, ovarian cancer, and a variety of solid tumors including breast cancer (Cancer Research 2012; 72:3901). We compared MiCK assay results in mesothelioma patients (pts) with NSCLC pts. Methods: Specimens from tissue or effusions were submitted to a central lab, processed to purify neoplastic cells, and a MiCK assay was performed as described (Cancer 2012; 118: 4877). Best chemotherapy regimens are defined as drugs/combinations with highest kinetic units (KU) of apoptosis +/- 1 SD compared to other drugs (this definition was predictive of outcomes in ovarian cancer). Active drugs have results over 1.0 KU of apoptosis. Results: 10 specimens have been submitted and 7 have been successful. Mean age was 69 and mean number of prior lines of therapy were 0.7 in 3 mesothelioma pts and 2.0 in 4 NSCLC pts. Mean number of drugs or combinations assayed successfully were 41 in mesothelioma and 20 in NSCLC. In mesothelioma, best active chemotherapy regimens (>1.0 KU) have been pemetrexed+doxorubicin, epirubicin, idarubicin, cyclophosphamide, ifosfamide, and dactinomycin. In NSCLC, best active regimens have been doxorubicin+cisplatin, irinotecan, and cyclophosphamide+doxorubicin+vincristine. In mesothelioma pts, the assay has been able to identify unexpected significant activity of several drugs: epirubicin, idarubicin, daunorubicin, dactinomycin, bendamustine, melphalan, vincristine, topotecan, azacytidine and bortezomib. Conclusions: Use of the MiCK assay in mesothelioma is at least as successful in the laboratory as it is in NSCLC. Unexpected new leads for innovative therapeutic strategies have been identified by the in vitro results. This feasibility study justifies a prospective controlled trial of the MiCK assay in mesothelioma and NSCLC pts. Clinical trials of drugs with unexpected activity are warranted in mesothelioma pts. Clinical trial information: NCT 01770665.


2021 ◽  
Author(s):  
Marta Dąbrowska-Bender ◽  
Robert Słoniewski ◽  
Urszula Religioni ◽  
Adam Fronczak ◽  
Anna Staniszewska ◽  
...  

Abstract Background A comparative analysis of changes in quality of life of women diagnosed with ovarian and breast cancer after surgical treatment followed by adjuvant cancer therapy. Methods The study covered 220 women diagnosed with ovarian (n = 89) or breast cancer (n = 131) after surgical treatment followed by adjuvant cancer therapy (chemotherapy, radiotherapy, hormone therapy). The tools used to measure the quality of life were: standardised EORTC QLQ-C30 questionnaire and QLQ-BR23 module for breast cancer and QLQ-OV28 module for ovarian cancer. Results The women with breast cancer rated their health higher than the women with ovarian cancer. The health assessment made by the patients was not related to the type of cancer (P > 0.05). They experienced pain, dyspnea and weakness regardless of the location of cancer. In addition, the health of the women had a significant impact on their family and social life, but nonetheless, no statistically significant differences were found between the two groups (P > 0.05). Whilst the patients with breast cancer rated their quality of life and health higher than the patients with ovarian cancer, the differences were not statistically significant (P > 0.05). Conclusions The results show that there is an urgent need to provide cancer patients with support of psycho-oncologists, medical staff, community (including organisations that help women with a specific type of cancer) and family members at each stage of the disease and therapy to improve the health and quality of life of the population.


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