MGMT gene polymorphisms in patients with severe hematological toxicity treated with temozolomide for adult diffuse gliomas: Results from a tertiary-care comprehensive cancer center.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e14032-e14032
Author(s):  
Prithwijit Moitra ◽  
Abhishek Chatterjee ◽  
Priti Khatri Kota ◽  
Pradnya Kowtal ◽  
Archya Dasgupta ◽  
...  
Keyword(s):  
Gene Polymorphisms ◽  
Mononuclear Cells ◽  
Tertiary Care ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Hematological Toxicity ◽  
Diffuse Glioma ◽  
Snp Analysis ◽  
Mgmt Gene ◽  
Diffuse Gliomas

e14032 Background: Polymorphisms in MGMT gene have been implicated in temozolomide (TMZ)-induced hematological toxicity in patients with adult diffuse gliomas. We aimed to investigate the association of three single nucleotide polymorphisms (SNPs) in the MGMT gene viz. L84F, I143V/K178R with severe hematological toxicity in patients of adult diffuse glioma treated with TMZ at an academic neuro-oncology unit of a tertiary-care comprehensive cancer centre from India. Methods: Thirty-three patients of adult diffuse glioma treated with multi-modality adjuvant therapy including TMZ who developed CTCAE V5.0 grade 2-4 hematological toxicity were included after written informed consent. Genomic DNA was extracted from peripheral blood mononuclear cells for SNP analysis. Correlation of MGMT SNP with patient demographics and hematological toxicity was assessed using the Chi-square and Fisher’s exact test. Results: Twenty-four patients (72.7%) developed grade 3-4 hematological toxicity with TMZ with a distinct female predilection. The variant T allele of L84F was expressed in 28.7% of the total 66 analyzed alleles which was markedly higher than previously reported in the general population of South Asian ancestry. The variant G allele of I43V/K178R was expressed in 9.3% (6/64) of 64 analyzed alleles. Persistent myelosuppression lasting beyond 2 months after cessation of TMZ correlated with I143V/K178R hetero/homozygous compared to wild type allele (p = 0.03). However, no significant correlation could be seen between any of the tested MGMT SNPs and grade of hematological toxicity. Conclusions: There is a higher prevalence of the L84F polymorphism in Indian patients with severe hematological toxicity than previously reported in the literature. The variant G allele of I143V/K178R is associated with prolonged and persistent myelosuppression induced by TMZ. A larger case-control is being planned to further elucidate the causal relationship between MGMT gene polymorphisms and TMZ-induced severe hematological toxicity.

Prevalence of antibiotic resistant strains in fecal surveillance cultures of patients from a new tertiary care cancer center in eastern part of India.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20686-e20686
Author(s):  
Vivek Sulekha Radhakrishnan ◽  
Gaurav Goel ◽  
Dipmala Das ◽  
Sriram Ravichandran ◽  
Vishvdeep Khushoo ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Antimicrobial Treatment ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cell Transplant ◽  
Drug Resistant ◽  
Intensive Chemotherapy ◽  
Haemopoietic Stem Cell ◽  
Surveillance Cultures ◽  
Hematological Cancers

e20686 Background: Drug resistant organisms are a very common cause of infections in critically ill patients in India. Surveillance Cultures is part of a multi-factorial approach to control MDRO[Multi-Drug Resistant Organisms]. Colonization surveillance may have the potential to improve empiric antimicrobial treatment in a critical care setting. Methods: Design: Retrospective. Setting: Newly started Comprehensive Cancer Center in Eastern part of India. Period: Dec 2011 - Jan 2013. Review of fecal surveillance cultures of patients undergoing intensive chemotherapy for hematological cancers or haemopoietic stem cell transplant. Fecal Surveillance cultures were done prior to Intensive Chemotherapy using a method based on Landman D et al (J Clin Microbiol 2005). Results: 48 patients [35 male,13 female] admitted with diagnoses of AML(22), ALL(6), APL(1), Acute Mixed Lineage Leukemia(1), MDS(1), Hodgkin Lymphoma(1), DLBCL(1), Fanconi Anemia(1), Multiple Myeloma(4), and Myeloproliferative Disorder(1) had information on Fecal Surveillance Cultures. Mean age: 35yrs [range; Male: 6-67yrs, Female:10-59yrs]. Total Samples collected: 67. Median sample per pateint: 1(range 1-4). All samples excepting one, grew MDRO isolates (98.5%). No. of Isolates:136 [95 gram negative bacilli (GNB), 41 gram positive cocci (GPC)]. Among GPC isolates, resistance to Ampicillin, Vancomycin, High level Gentamycin, and Linezolid were 86.5% (32/37), 7.3%(3/41), 60.9%(25/41) and nil(0/41) respectively. Among GNB isolates, resistance to Cefotaxime, Ciprofloxacin, Co-Amoxiclav, Gentamycin, Amikacin, Piperacillin-Tazobactum, Meropenem and Colistin were respectively 90.8%(79/87), 67.4%(60/89), 67.4%(60/89), 45.2%(43/95), 23.4%(22/94), 39.7%(37/93), 25.8%(24/93) and 6.4%(5/78). In the coliform group, the prevalence of ESBL/Amp-C producing isolates was 91.7%. Carbapenamase production was noted in 25.8% of GNB isolates. Conclusions: There is a very high prevalence of background antimicrobial resistance in the enteric flora of patients receiving intensive chemotherapy at our center. The causes of widespread MDRO in our setting needs further studies.

Improving the quality of life of geriatric cancer patients with a structured multidisciplinary intervention: A randomized controlled trial

2007 ◽  
Vol 5 (2) ◽  
pp. 107-114 ◽  
Author(s):  
MARIA I. LAPID ◽  
TERESA A. RUMMANS,. ◽  
PAUL D. BROWN ◽  
MARLENE H. FROST ◽  
MARY E. JOHNSON ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Advanced Cancer ◽  
Tertiary Care ◽  
Intervention Group ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Controlled Clinical Trial ◽  
Elderly Age

Objective: To examine the potential impact of elderly age on response to participation in a structured, multidisciplinary quality-of-life (QOL) intervention for patients with advanced cancer undergoing radiation therapy.Methods: Study design was a randomized stratified, two group, controlled clinical trial in the setting of a tertiary care comprehensive cancer center. Subjects with newly diagnosed cancer and an estimated 5-year survival rate of 0%–50% who required radiation therapy were recruited and randomly assigned to either an intervention group or a standard care group. The intervention consisted of eight 90-min sessions designed to address the five QOL domains of cognitive, physical, emotional, spiritual, and social functioning. QOL was measured using Spitzer uniscale and linear analogue self-assessment (LASA) at baseline and weeks 4, 8, and 27.Results: Of the 103 study participants, 33 were geriatric (65 years or older), of which 16 (mean age 72.4 years) received the intervention and 17 (mean age 71.4 years) were assigned to the standard medical care. The geriatric participants who completed the intervention had higher QOL scores at baseline, at week 4 and at week 8, compared to the control participants.Significance of results: Our results demonstrate that geriatric patients with advanced cancer undergoing radiation therapy will benefit from participation in a structured multidisciplinary QOL intervention. Therefore, geriatric individuals should not be excluded from participating in a cancer QOL intervention, and, in fact, elderly age may be an indicator of strong response to a QOL intervention. Future research should further explore this finding.

scholarly journals Incidence and Immunomic Features of Apyretic COVID-19 in Patients Affected by Solid Tumors: A Prospective Cohort Study.

2021 ◽  
Author(s):  
Francesco Ravera ◽  
Roberto Borea ◽  
Gabriella Cirmena ◽  
Martina Dameri ◽  
Lorenzo Ferrando ◽  
...  
Keyword(s):  
Mononuclear Cells ◽  
Seroconversion Rate ◽  
Cell Receptor ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Nasopharyngeal Swab ◽  
Solid Cancer ◽  
Peripheral Blood Mononuclear ◽  
Kegg Pathways ◽  
Asymptomatic Patients

Abstract Background and rationale: Little is known about SARS-CoV-2 seroconversion in asymptomatic patients affected by solid cancer, and whether it is associated with specific transcriptomics changes in peripheral blood mononuclear cells (PBMC).Methods: patients affected by solid cancer treated in a top comprehensive cancer center in Italy during the first COVID-19 pandemic wave, and negative for COVID-19-symptoms since the first detection of COVID-19 in Italy, were prospectively evaluated by SARS-CoV-2 serology in the period between April 14th and June 23rd 2020. Follow-up serologies were performed, every 21-28 days, until August 23rd, 2020. All SARS-CoV-2 IgM+ patients underwent confirmatory nasopharyngeal swab (NPS). PBMCs from a subset of SARS-CoV-2 IgM+ patients were collected at baseline, at 2 months, and at 7 months for transcriptome sequencing.Results: SARS-CoV-2 serology was performed on 446 of the 466 recruited patients. A total of 14 patients (3.14 %) tested positive for at least one SARS-CoV-2 immunoglobulin in the period between April 14th and August 23rd 2020. Viral RNA could not be detected in any of the NPS. PBMC serial transcriptomic analysis showed progressive downregulation of interleukin 6 upregulated signatures, chemokine-mediated signaling and chemokine-chemokine receptor KEGG pathways. B- and T-cell receptor pathways (p-values = 0.0002 and 0.017 respectively) were progressively upregulated.Conclusions: SARS-CoV-2 seroconversion rate in asymptomatic patients affected by solid cancer is consistent with that of asymptomatic COVID-19 assessed in the general population through NPS at the peak of the first wave. Transcriptomic features over time in IgM+ asymptomatic cases are strongly indicative of previous viral exposure.

Brain metastases (BMs) from metastatic renal cell carcinoma (RCC) in patients (pts) treated with molecularly targeted agents (MTAs).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15066-e15066
Author(s):  
Haris Ali ◽  
Jingsheng Yan ◽  
Yull Edwin Arriaga ◽  
Xian-Jin Xie ◽  
James Brugarolas
Keyword(s):  
Proportional Hazards Model ◽  
Care Center ◽  
Tertiary Care ◽  
Cox Proportional Hazards Model ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Increased Risk ◽  
The Impact ◽  
Metastatic Rcc

e15066 Background: Historically, the frequency of BMs from RCC is ~11%. Recent reports have suggested an improvement in the incidence of BMs with tyrosine kinase inhibitors (TKIs). What is not known is the impact of MTAs on the prevalence of BMs in metastatic RCC. Methods: We conducted a retrospective review of all pts with metastatic RCC treated with MTAs at a tertiary care center, UT Southwestern Harold C. Simmons Comprehensive Cancer Center, from 2006–2010. Statistical analyses were performed using the Cox proportional hazards model and the Kaplan-Meier method. Results: Fifty nine pts met inclusion criteria. 8 more pts presented with BMs and were not included in the incidence and survival analyses. Median age was 64.6 yrs. Per MSKCC criteria, 3 pts were in favorable (5%), 41 in intermediate (70%), and 15 in poor (25%) prognostic groups. Sites of metastases at presentation included lungs (65%), lymph nodes (40%), bones (30%), and liver (25.4%). Mean follow up time was 16 months, and at last follow up 24 pts were alive. The incidence of BMs was 11.9% (7/59) and the prevalence was 22% (15/67). Median overall survival was 1.97 yrs (95% CI, 1.04-3.89). Median survival for pts who developed BMs vs. without BMs was 1.21 yrs vs. 1.98 yrs (p=0.17). In multivariable analyses, only lack of nephrectomy was associated with increased risk of BMs, HR=9.819 (95 CI, 1.65-58.38; p=0.012). Conclusions: In our study, the incidence of BMs in RCC pts treated with MTAs was similar to what has been historically reported. In contrast, the prevalence of BMs was much higher at 22%. This is the first study to report the prevalence of BMs in patients with metastatic RCC treated with MTAs. As in other tumor types, the life-time risk of BMs appears to increase with the availability of highly-active MTAs.

scholarly journals Physicians' Attitudes About Multiplex Tumor Genomic Testing

2014 ◽  
Vol 32 (13) ◽  
pp. 1317-1323 ◽  
Author(s):  
Stacy W. Gray ◽  
Katherine Hicks-Courant ◽  
Angel Cronin ◽  
Barrett J. Rollins ◽  
Jane C. Weeks
Keyword(s):  
Tertiary Care ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cancer Genes ◽  
Multiple Cancer ◽  
Genomic Knowledge ◽  
Medical Oncologists ◽  
Uncertain Significance ◽  
Evidence Based Guidelines ◽  
Multiplex Testing

Purpose Although predictive multiplex somatic genomic tests hold the potential to transform care by identifying targetable alterations in multiple cancer genes, little is known about how physicians will use such tests in practice. Participants and Methods Before the initiation of enterprise-wide multiplex testing at a major cancer center, we surveyed all clinically active adult cancer physicians to assess their current use of somatic testing, their attitudes about multiplex testing, and their genomic confidence. Results A total of 160 physicians participated (response rate, 61%): 57% were medical oncologists; 29%, surgeons; 14% radiation oncologists; 37%, women; and 83%, research principal investigators. Twenty-two percent of physicians reported low confidence in their genomic knowledge. Eighteen percent of physicians anticipated testing patients infrequently (≤ 10%), whereas 25% anticipate testing most patients (≥ 90%). Higher genomic confidence was associated with wanting to test a majority of patients (adjusted odds ratio [OR], 6.09; 95% CI, 2.1 to 17.5) and anticipating using actionable (adjusted OR, 2.46; 95% CI, 1.2 to 5.2) or potentially actionable (adjusted OR, 2.89; 95% CI, 1.1 to 7.9) test results to inform treatment recommendations. Forty-two percent of physicians endorsed disclosure of uncertain genomic findings to patients. Conclusion Physicians at a tertiary-care National Cancer Institute–designated comprehensive cancer center varied considerably in how they planned to incorporate predictive multiplex somatic genomic tests into practice and in their attitudes about the disclosure of genomic information of uncertain significance. Given that many physicians reported low genomic confidence, evidence-based guidelines and enhanced physician genomic education efforts may be needed to ensure that genomically guided cancer care is adequately delivered.

The prevalence of cognitive impairment in older Indian persons with cancer and brain metastases.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24019-e24019
Author(s):  
Aditya Dhanawat ◽  
Vanita Noronha ◽  
Anant Ramaswamy ◽  
Shreya Gattani ◽  
Renita Castelino ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Brain Metastases ◽  
Older Persons ◽  
Tertiary Care ◽  
Geriatric Oncology ◽  
Therapeutic Interventions ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cranial Radiotherapy ◽  
Chi Square

e24019 Background: Normal aging is associated with a decline in neurocognitive abilities. Regardless of age, 42% to 91% of persons with cancer and brain metastases are reported to have neurocognitive impairment. There are no data regarding the prevalence of cognitive impairment in older persons with cancer and brain metastasis. Methods: This retrospective analysis was performed on a prospectively collected dataset of patients who attended the geriatric oncology clinic at the Tata Memorial Hospital, a tertiary-care comprehensive cancer center in India from June 2018 to February 2021. Patient aged 60 years and over with malignancy were included. Cognition was assessed with the mini-mental status examination (MMSE); the Hindi MMSE was used for illiterate patients. A score of < 23 on the MMSE was considered abnormal. Correlation between the presence of cognitive impairment and brain metastases was tested using the chi-square test. Results: A total of 401 patients were included, of which 318 (79.3%) were males. The median age was 70 years (range: 60-100 years). All patients had solid tumors; 162 (40.4%) had lung, 139 (34.7%) had gastrointestinal and 48 (12%) had head and neck malignancies. Twenty-five (6.2%) patients had brain metastases, of which 5 (20%) had solitary, 19 (76%) had multiple lesions, and 1 (4%) had leptomeningeal metastases. Cognitive impairment was noted in 4 (16%) of the 25 patients with brain metastases and 61 (16.2%) out of 376 patients without brain metastases. There was no significant correlation between the presence of brain metastases and cognitive impairment, p = 0.57. Conclusions: Older persons with cancer and brain metastases do not have a higher incidence of cognitive impairment than those without brain metastases. The next step is to understand whether older persons with brain metastases are more at risk for cognitive decline as a result of therapeutic interventions such as cranial radiotherapy and chemotherapy.

ASCO-GU 2019: Fortgeschrittenes Nierenzellkarzinom

2019 ◽  
Vol 10 (02) ◽  
pp. 75-76
Author(s):  
Ine Schmale
Keyword(s):  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Washington Dc

Das Armamentarium zur Behandlung des Nierenzellkarzinoms (RCC) hat sich um effektive Therapien erweitert, durch die der Therapiealgorithmus komplett umgestellt werden musste. Prof. Michael B. Atkins vom Georgetown-Lombardi Comprehensive Cancer Center, Washington DC/USA, und Prof. Daniel Y. C. Heng vom Tom Baker Cancer Center, Calgary/Kanada, teilten beim ASCO-GU ihre Einschätzung zur optimalen Behandlung des Nierenzellkarzinoms in der Erst- und Zweitlinientherapie für das Jahr 2019.

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