Human papillomavirus pevalence and persistence after chemoradiotherapy for carcinoma of the uterine cervix.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15525-e15525
Author(s):  
Maria Fernanda Noriega-Iriondo ◽  
Laura Elia Martinez Garza ◽  
Juan Francisco Gonzalez Guerrero ◽  
Oralia Barboza Quintana ◽  
Daneli Ruiz Sanchez ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Clinical Response ◽  
Dna Microarrays ◽  
Clinical Stage ◽  
Complete Response ◽  
Viral Clearance ◽  
Hpv Types ◽  
Prognostic Implications ◽  
Lost To Follow Up

e15525 Background: Human papillomavirus (HPV) is associated with carcinoma of the cervix (CC). There is evidence that clearance of the virus occurs after chemoradiotherapy which is the standard treatment for this disease. Methods: Eligible patients with bulky IB to IVA CC were treated with once weekly cisplatin (40 mg/m2) chemotherapy and standard pelvic teletherapy and brachyterapy. HPV detection and typing was performed with DNA microarrays from liquid based cytologies before and 4 to 6 weeks after treatment completion. Clinical response was assesed by physical exam and liquid based cytology. Results: 23 patients (pt) with CC , were tested for HPV. Their age ranged from 33 to 80 years (mean 65), clinical stage I 8.6%, StageII 39%, stageIII 25.9% and stageIV 26.5%.VPH was found in 20 patients (87%). 34% of the patients had more than one type of HPV. 13 types of VPH were found,the most prevalent type was 16 in 47.8%, followed by type 72 in 13%.7 patients were lost to follow up during therapy. 16 patients were tested after completion of therapy ,there was HPV persistence in 5 patients (38.5%),whereas 61.5% cleared the virus. Of the persisting HPV the most prevalent type was 16 in two pt. and 61 in two pt. three pt had more than one HPV type after completion of therapy (types 11,81,35,39,56,84,66were found in different combinations in the pts). Response rate was as follows, 84.6% complete response,and two pt. had partial response. Viral clearance did not correlate with complete response in this study. Conclusions: HPV types 16 and 72 were the most prevalent in this population from northern Mexico. Infection with multiple viral types was common. Viral clearance occured in 61.5% and this did not correlate with complete clinical response. Persistence of multiple HPV types after completion of therapy may have unknown clinical and prognostic implications.

scholarly journals Salvage therapy with Sodium chlorosum (formerly DAC N-055) for cases of refractory lupoid cutaneous leishmaniasis: results from a compassionate use study with 0.09% Sodium chlorosum in amphiphilic basic cream

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara Molkara ◽  
Elaheh Poursoltani ◽  
Kurt-Wilhelm Stahl ◽  
Masoud Maleki ◽  
Ali Khamesipour ◽  
...  
Keyword(s):  
Clinical Response ◽  
Cutaneous Leishmaniasis ◽  
Controlled Trial ◽  
Complete Response ◽  
Sodium Chlorite ◽  
Registration Number ◽  
One Year ◽  
The One ◽  
Lost To Follow Up

Abstract Background Lupoid cutaneous leishmaniasis (LCL) is known as a rare but serious complication of anthroponotic cutaneous leishmaniasis (ACL) resistant to conventional treatments. Sodium chlorosum, a pro-oxidative preparation of pharmaceutical sodium chlorite (NaClO2), has been successfully used for the treatment of Old World cutaneous leishmaniasis lesions (OWCL) and of some LCL cases in Afghanistan. This clinical trial study aimed to evaluate the effect of a last resort therapy with topical 0.09% sodium chlorosum on LCL in Iran. Methods Twenty Iranian patients (12 women and 8 men) with LCL refractory to treatment were included in this salvage study. A magistral preparation of sodium chlorosum (10 mM NaClO2 in amphiphilic basic cream) was applied twice daily to the lesions for 6 weeks and continued up to 12 weeks in patients who showed a clinical response within the first 6 weeks. Responders were followed up for a maximum of 1 year. Lesions were photographed during weekly visits. Disappearance of erythema and indurated lesions were rated as complete clinical response. Results Patients with a mean age of 28.6 (±24.3) and with an ACL proven lesion history of 3.8 (±1.4) years were treated for an average of 7.9 (±1.8) weeks. At the end of the treatment period (12th week), a complete response was observed in 9 of 20 patients (45%). During the one-year follow-up period, LCL lesions recurred in 4 of these 9 patients (with one patient showing only a tiny lesion) and one case lost to follow up whereas the other four remained completely lesion-free. Mild temporary side-effects such as erythema and itching were seen in 4 of 20 patients (20%). Conclusions Topical sodium chlorosum showed promising therapeutic results and can be considered as safe, painless, and relatively effective treatment for LCL, an ethical prerequisite for a two-armed controlled trial. Trial registration This study was registered in Iranian registry of clinical trials on 2019-02-02 with registration number IRCT20190114042356N1.

Lessons from pathological analysis of recurrent early esophageal squamous cell neoplasia after complete endoscopic radiofrequency ablation

Endoscopy ◽  
2018 ◽  
Vol 50 (08) ◽  
pp. 743-750 ◽  
Author(s):  
Wen-Lun Wang ◽  
I-Wei Chang ◽  
Chien-Chuan Chen ◽  
Chi-Yang Chang ◽  
Cheng-Hao Tseng ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Local Recurrence ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Complete Response ◽  
Primary Treatment ◽  
Long Term Follow Up ◽  
Endoscopic Radiofrequency Ablation ◽  
Lost To Follow Up

Abstract Background Endoscopic radiofrequency ablation (RFA) is a treatment option for early esophageal squamous cell neoplasia (ESCN); however, long-term follow-up studies are lacking. The risks of local recurrence and “buried cancer” are also uncertain. Methods Patients with flat-type ESCN who were treated with balloon-type ± focal-type RFA were consecutively enrolled. Follow-up endoscopy was performed at 1, 3, and 6 months, and then every 6 months thereafter. Endoscopic resection was performed for persistent and recurrent ESCN, and the histopathology of resected specimens was assessed. Results A total of 35 patients were treated with RFA, of whom 30 (86 %) achieved a complete response, three were lost to follow-up, and five (14 %) developed post-RFA stenosis. Two patients had persistent ESCN and received further endoscopic resection, in which the resected specimens all revealed superficial submucosal invasive cancer. Six of the 30 patients with successful RFA (20 %) developed a total of seven episodes of local recurrence (mean size 1.4 cm) during the follow-up period (mean 40.1 months), all of which were successfully resected endoscopically without adverse events. Histological analysis of the resected specimens revealed that six (86 %) had esophageal glandular ductal involvement, all of which extended deeper than the muscularis mucosae layer. Immunohistochemistry staining for P53 and Ki67 suggested a clonal relationship between the ductal involvement and epithelial cells. None of the tumors extended out of the ductal structure; no cases of cancer buried beneath the normal neosquamous epithelium were found. Conclusions Because ductal involvement is not uncommon and may be related to recurrence, the use of RFA should be conservative and may not be the preferred primary treatment for early ESCN.

Combined neoadjuvant weekly paclitaxel and trastuzumab for HER2-overexpressing breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 3045-3045
Author(s):  
J. Horiguchi ◽  
Y. Koibuchi ◽  
N. Rokutanda ◽  
R. Nagaoka ◽  
M. Kikuchi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pathological Complete Response ◽  
Clinical Stage ◽  
Radical Mastectomy ◽  
Complete Response ◽  
Breast Conserving Surgery ◽  
Weekly Paclitaxel ◽  
Her2 Positive ◽  
Positive Breast Cancer

3045 Background: The purpose of this study is to determine the clinical efficacy of neoadjuvant paclitaxel and trastuzumab in women with advanced breast cancer, with or without metastatic disease. Methods: Patients with HER2-positive breast cancer (clinical stage IIB-IV) were included in this study. The patients received trastuzumab 4mg/kg loading dose intravenously then 2mg/kg weekly and concurrently paclitaxel 80mg/m2 (Day 1, 8, 15) weekly for 4 cycles followed by surgery. Results: Preliminary results from 15 patients are reported. Of these, six patients (40%) had a clinical complete response and nine patients (60%) a clinical partial response. Fourteen of 15 patients received surgery; eight breast-conserving surgery and six modified radical mastectomy. Six patients (43%) had pathological complete response. With a median follow-up of 19 months (range, 5–32 months), these 15 patients are alive. Patients with clinical stage IIB-III breast cancer are alive without any distant metastasis. Conclusion: Combined neoadjuvant weekly paclitaxel and trastuzumab had high clinical and pathological response rates for HER2 overexpressing breast cancer. No significant financial relationships to disclose.

Outcomes of progression on surveillance for clinical stage I nonseminomatous germ cell tumours (NSGCT).

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 377-377 ◽  
Author(s):  
Robert James Hamilton ◽  
Madhur Nayan ◽  
Lynn Anson-Cartwright ◽  
Philippe L. Bedard ◽  
Malcolm Moore ◽  
...  
Keyword(s):  
Clinical Stage ◽  
Complete Response ◽  
Primary Treatment ◽  
Testis Cancer ◽  
First Year ◽  
Retroperitoneal Lymphadenectomy ◽  
Mode Of Detection ◽  
Single Modality ◽  
Do So

377 Background: Active surveillance (AS) is universally accepted for clinical stage (CS) IA and favoured by most centers for CSIB. Patients progressing on AS are typically treated with chemotherapy, but there is no consensus. We describe patterns and mode of detection of progression and treatment of progression in our NSGCT AS cohort. Methods: From Dec 1980 to Aug 2011, 466 CSI NSGCT patients were managed with AS and 133 (28%) had disease progression while on AS. Treatment upon progression was physician choice but based on site of progression (e.g. retroperitoneum vs. extra-retroperitoneal), size or multifocality, and markers (S0 or stable, low level S1 vs. ≥ S1). Mode of detection of progression, characteristics at progression and primary treatment of progression (chemotherapy vs. retroperitoneal lymphadenectomy (RPLND)) were explored. Multivariate logistic regression was used to explore factors associated with receipt of more than one therapy in treatment of progression after surveillance. Results: Median time to progression was 7.3 months and detected by routine imaging (47%), routine serum tumour markers (37%), or both (12%). Progression most frequently occurred in the retroperitoneum (67%). Following progression, first-line treatment was chemotherapy for 71 (53%), RPLND for 51 (38%) and 11 (8.3%) underwent other therapy. In 59%, only one modality of treatment was required: chemotherapy only in 42/71 (59%); RPLND only in 36/51 (71%). For those treated with chemotherapy, pure embryonal carcinoma in the orchiectomy pathology (OR 0.11; p=0.05) was inversely associated with requiring further therapy. For those treated with RPLND, elevated markers pre-RPLND (OR 7.31; p=0.01) was associated with requiring further therapy. Overall, a second relapse occurred in 25/133 (19%) patients. With a median follow-up of 8.2 years, there were 5 deaths from testis cancer (3.8% of AS progressors; only 1.1% of overall AS cohort). Conclusions: The majority of patients progressing on surveillance do so in the retroperitoneum and within the first year. Of those that progress, most will achieve complete response with single modality treatment. In particular, RPLND can be utilized as monotherapy in select cases.

scholarly journals Evaluation of the Long-Term Anti-Human Papillomavirus 6 (HPV6), 11, 16, and 18 Immune Responses Generated by the Quadrivalent HPV Vaccine

2015 ◽  
Vol 22 (8) ◽  
pp. 943-948 ◽  
Author(s):  
Mari Nygård ◽  
Alfred Saah ◽  
Christian Munk ◽  
Laufey Tryggvadottir ◽  
Espen Enerly ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Geometric Mean ◽  
Strongly Correlated ◽  
Serum Samples ◽  
Base Study ◽  
Long Term Follow Up ◽  
Hpv Types ◽  
Current Report

ABSTRACTThis quadrivalent human papillomavirus (qHPV) (HPV6, -11, -16, and -18) vaccine long-term follow-up (LTFU) study is an ongoing extension of a pivotal clinical study (FUTURE II) taking place in the Nordic region. The LTFU study was designed to evaluate the effectiveness, immunogenicity, and safety of the qHPV vaccine (Gardasil) for at least 10 years following completion of the base study. The current report presents immunogenicity data from testing samples of the year 5 LTFU visit (approximately 9 years after vaccination). FUTURE II vaccination arm subjects, who consented to being followed in the LTFU, donated serum at regular intervals and in 2012. Anti-HPV6, -11, -16, and -18 antibodies were detected by the competitive Luminex immunoassay (cLIA), and in addition, serum samples from 2012 were analyzed by the total IgG Luminex immunoassay (LIA) (n= 1,598). cLIA geometric mean titers (GMTs) remained between 70% and 93% of their month 48 value depending on HPV type. For all HPV types, the lower bound of the 95% confidence interval (CI) for the year 9 GMTs remained above the serostatus cutoff value. The proportion of subjects who remained seropositive based on the IgG LIA was higher than the proportion based on cLIA, especially for anti-HPV18. As expected, the anti-HPV serum IgG and cLIA responses were strongly correlated for all HPV types. Anti-HPV GMTs and the proportion of vaccinated individuals who are seropositive remain high for up to 9 years of follow-up after vaccination.

Evaluation of Response to Anti-CD20 (Rituximab) Trial in Relapsed Follicular Lymphoma after Six Years in Follow-Up.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4784-4784
Author(s):  
Araceli Rubio-Martinez ◽  
Luis Palomera ◽  
Valle Recasens ◽  
Maria J. Najera ◽  
Matilde Perella ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Clinical Response ◽  
Clinical Stage ◽  
Prospective Trial ◽  
Molecular Response ◽  
Tumour Mass ◽  
Inform Consent ◽  
Frequent Relapses ◽  
Anti Cd20

Abstract Background: Follicular Lymphoma (FL) is characterized by t(14:18)(q32;q21) in 80% patients. Persistence of expression bcl2/JH gene translocation is related to frequent relapses in FL. Purpose: To determine the efficacy of Fludarabine-Mitoxantrone (FLD/MTX) + monoclonal anti CD20 antibody (Rituximab) to induce clinical and molecular response in relapsed FL in base to the presence of bcl-2. Methods: Prospective trial in 31 patients with relapsed FL. An outpatient regimen i.v./28d: FLD 30 mg/m2 1–3 + MTX 10 mg/m2 1 followed by Rituximab (375 mg/m2/weekly x4). Eligibility criteria: adults patients with both (relapsed FL by biopsy + bcl-2 immunohistochemistry expression in nodal biopsy), ECOG<3, normal renal function and liver tests. Exclusion criteria: previous anti-CD20 therapy, chemotherapy within 4 weeks previously, other malignancies, AIDS or other infectious disease. Patients were eligible for registration previous inform consent. Evaluation at baseline included: complete blood counts, serum and urine biochemistry, b2 microglobuline and LDH, body scan, bone marrow (BM) biopsy and PCR-ELISA for t(14;18) in BM. Patients were classified according ECOG, clinical stage and FLIPI. Follow-up monitoring: after FLD/MTX and 2 months after Rituximab, including clinical examination, laboratory, scan, BM examination and t(14;18). Response criteria: Complete remision (CR):resolution tumour mass and BM involvement; partial remission (PR):>75% reduction in tumour mass and BM infiltration <10%. Progression: increase in measurable mass lesion >25% during therapy. Molecular remision (MR): negative PCR-ELISA assay in BM. Statistical analysis: descriptive and frequency distribution, overall survival (OS), relapsed free survival (RFS). Survival curves were estimated using Kaplan-Meier survival analysis. Results: Mar-99 to July03, 31 patients with relapsed FL were enrolled. Mean age: 56.00± 12.44 (range 32–77); M/F: 13/18. ECOG: 0(22), 1(5), 2(2), 3(2). Clinical stage II(4), III(8), IV(19). Previous therapies 1(19), 2(4), and 3 or more(8), FLIPI 0 (3), 1(6), 2(15), 3(7). PCR t(14:18) was positive in BM in 12 cases (40 %). Response: after FLD-MTX, clinical response was obtained in 27 patients, CR 13 (43.3%) and PR 14(46.67%), 2 failed. One not valuable. Rituximab started in 27/28 patients with clinical response (1 refused). After Rituximab: CR 23 (81.4%), PR 4(13.3%) and 2 failures (6.4%) After Rituximab (26 responsive patients): 22 (84.6%) achieved MR, 4 (15.3%) persist PCR-ELISA positive in BM. PBSCT was underwent in 14 CR patients (63.6%). OS: 117 months (range 36–200), median RFS 44,22 months (range 0–73). Relapse was observed in 13(43,3%) and 8 died, only one patient had persistence of t(14;18), mean time to relapse 24.1 m (0–57), 3 patients relapsed after PBSCT. Four patients in CR have died by other causes. Nowadays17 patients remain alive and 12 are in CR. Conclusions: The response to FLD-MTX is obtained in 90 % of patients with relapsed FL, with CR rates 43.3%. The addition of Rituximab does not influence on overall response but improves CR rates (81.4%). The median RFS of group is 117 months only 13 patients developed relapse apparently it is not related to persistence of t(14;18).

Rituximab Treatment in Childhood Chronic Immune Thrombocytopenic Purpura (ITP).

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4461-4461 ◽  
Author(s):  
Ji Yoon Kim ◽  
Kun Soo Lee ◽  
Hyoung Jin Kang ◽  
Hoon Kook ◽  
Hong Hoe Koo ◽  
...  
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Medical Records ◽  
Conflicts Of Interest ◽  
Complete Response ◽  
Thrombocytopenic Purpura ◽  
Chronic Itp ◽  
New Treatment ◽  
Lost To Follow Up

Abstract Abstract 4461 Background Immune thrombocytopenic purpura (ITP) is characterized by mucocutaneous purpura and thrombocytopenia caused by circulating anti-platelet auto-antibodies. ITP is usually self-limited in children, but around 20% of patients will develop chronic ITP. The conventional treatments for children chronic ITP include intravenous immunoglobulin (IVIG), corticosteroid therapy, anti-D immune globulin, or splenectomy. Some children with chronic ITP are refractory to these treatments and nowadays begun to try new treatment agents such as rituximab. Rituximab as a monoclonal antibody to CD-20, has shown promising reports to these patients with refractory chronic ITP in adults groups and a few children groups. We investigated this study to evaluate the efficacy of rituximab for childhood chronic ITP in Korea. Methods We reviewed the questionnaires and medical records about the clinical progresses and results in thirteen children from eight clinical institutes, retrospectively. Complete response (CR) was considered if the platelet count was > 100,000/uL. Results Thirteen patients with chronic thrombocytopenia who had been treated with rituximab were investigated. Two patients were lost to follow-up after rituximab. Finally eleven patients were evaluated including one patient with Evans syndrome. Median age was 6.5 year (range, 0.5 ∼ 15.4). Median platelet count at baseline was 13,700/uL (3,000∼46,000). All patients had been treated with conventional therapy including IVIG and steroids. One had done splenectomy. Median follow-up duration was 2.8 years (1.1-5.9). Among 11 patients, CR was achieved in 3 patients (27%). Their platelet count prior to rituximab were < 10,000/uL. They were treated as the regimen of 375 mg/m2/dose weekly for 4 doses. Time from the first rituximab dose to achievement of complete response was 3.9, 4.9 and 5.7 weeks respectively. One patient who was relapsed 6months after the first course of rituximab was received second course of rituximab using the same regimen and achieved a new CR at 9.3 weeks after. There were no reports about severe complication or interruption of medication. Conclusions Therefore, we suggest that rituximab is effective treatment choice in childhood refractory chronic ITP and well tolerated. Disclosures: No relevant conflicts of interest to declare.

Intra-Arterial Chemotherapy for Muscle-Invasive Bladder Cancer Following Transurethral Resection

2015 ◽  
Vol 94 (4) ◽  
pp. 406-411 ◽  
Author(s):  
Shengjie Liang ◽  
Qingsong Zou ◽  
Bangmin Han ◽  
Yifeng Jing ◽  
Di Cui ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Clinical Stage ◽  
Complete Response ◽  
Intravesical Instillation ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Bladder Preservation ◽  
Muscle Invasive

Purpose: To assess the efficacy of intra-arterial chemotherapy as a bladder-preservation treatment in patients with muscle-invasive bladder cancer (MIBC) following transurethral resection of bladder tumors (TURBT). Materials and Methods: From 2005 June to 2012 November, 46 patients diagnosed with MIBC (clinical stage T2-T3N0M0) underwent three courses of cisplatin-based intra-arterial chemotherapy as a remedial approach for bladder preservation after TURBT. All patients also received intravesical instillation of chemotherapy as a maintenance strategy. Results: All 46 patients completed the treatment with minor complications. The median follow-up time was 34.5 months (range, 8-87 months). Thirty-two patients (69.6%) demonstrated complete response. The three-year and five-year overall survival was 70.65 and 61.23%, and the disease-specific survival over the same periods was 78.03 and 67.62%, respectively. During the entire follow-up period, more than 80% preserved their bladder. Conclusions: Intra-arterial chemotherapy can be performed as a remedial treatment for MIBC patient following TURBT. Combined with TURBT, it offers an option for bladder preservation therapy on patients who are unable or unwilling to undergo radical cystectomy.

scholarly journals Human papillomavirus genotypes in cervical cancers in Mozambique

2004 ◽  
Vol 85 (8) ◽  
pp. 2189-2190 ◽  
Author(s):  
Pontus Naucler ◽  
Flora Mabota da Costa ◽  
Otto Ljungberg ◽  
Antonio Bugalho ◽  
Joakim Dillner
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Case Series ◽  
Cervical Neoplasia ◽  
Consecutive Case ◽  
Substantial Impact ◽  
Cervical Cancers ◽  
Hpv Types ◽  
Oncogenic Hpv

The distribution of human papillomavirus (HPV) types in cervical cancers is essential for design and evaluation of HPV type-specific vaccines. To follow up on a previous report that HPV types 35 and 58 were the dominant HPV types in cervical neoplasia in Mozambique, the HPV types in a consecutive case series of 74 invasive cervical cancers in Mozambique were determined. The most common worldwide major oncogenic HPV types 16 and 18 were present in 69 % of cervical cancers, suggesting that a vaccine targeting HPV-16 and -18 would have a substantial impact on cervical cancer also in Mozambique.

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