scholarly journals Organ preservation treatment for locally advanced laryngeal cancer at the Comprehensive Cancer Center of Kyoto University

Toukeibu Gan ◽  
2012 ◽  
Vol 38 (4) ◽  
pp. 447-453
Author(s):  
Shigeru Hirano ◽  
Morimasa Kitamura ◽  
Ichiro Tateya ◽  
Seiji Ishikawa ◽  
Shinpei Kada ◽  
...  
Keyword(s):  
Laryngeal Cancer ◽  
Organ Preservation ◽  
Locally Advanced ◽  
Comprehensive Cancer Center ◽  
Cancer Center

Incidence of cutaneous reactions with pemetrexed: Comparison of patients who received three days of oral dexamethasone twice daily to patients who did not

2018 ◽  
Vol 25 (7) ◽  
pp. 1645-1650 ◽  
Author(s):  
Stefanie K Clark ◽  
Lisa M Anselmo
Keyword(s):  
New Mexico ◽  
Locally Advanced ◽  
Intervention Group ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Control Group ◽  
University Of New Mexico ◽  
Oral Dexamethasone ◽  
Significant Difference ◽  
Cutaneous Reactions

Pemetrexed is a multitargeted antifolate indicated for locally advanced or metastatic non-squamous non-small-cell lung cancer and malignant pleural mesothelioma. Cutaneous reactions are associated with pemetrexed use. Pemetrexed prescribing information recommends oral dexamethasone 4 mg twice daily for three days starting the day before pemetrexed infusion to prevent cutaneous reactions. Patients receive intravenous dexamethasone before pemetrexed infusion at the University of New Mexico Comprehensive Cancer Center, but the oral dexamethasone recommendation is not always followed. The objective of this study was to determine if there is a difference between patients who received three days of oral dexamethasone starting the day before pemetrexed infusion and patients who did not by determining incidence of cutaneous reactions, delay in therapy, and therapy change due to adverse reactions. Eighty-five patients received at least one dose of pemetrexed between August 1, 2012 and August 31, 2017. Twenty-nine patients did not receive three days of oral dexamethasone 4 mg twice daily and 56 patients did (34.1% vs. 65.9%). There was no statistically significant difference in the incidence of cutaneous reactions between the intervention group and the control group (13.8% vs. 25.0%; p = 0.384), delay in pemetrexed therapy between groups (44.8% vs. 32.1%; p = 0.2), or therapy change due to adverse events (34.5% vs. 23.2%; p = 0.654). Results suggest three days of oral dexamethasone 4 mg twice daily did not significantly affect incidence rates of cutaneous reactions, delay in therapy, or therapy change in patients who received intravenous dexamethasone before pemetrexed infusion at University of New Mexico Comprehensive Cancer Center.

Multi-institutional phase II trial of single agent regorafenib in refractory advanced biliary cancers.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. TPS468-TPS468
Author(s):  
Heloisa P. Soares ◽  
Nishi Kothari ◽  
Amit Mahipal ◽  
Gregory M. Springett ◽  
Jongphil Kim ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Phase Ii ◽  
Cancer Biology ◽  
Kinase Inhibitor ◽  
Single Agent ◽  
Locally Advanced ◽  
Drug Benefit ◽  
Rational Approach ◽  
Comprehensive Cancer Center ◽  
Cancer Center

TPS468 Background: Currently, there is no standard second line treatment for patients with advanced biliary tract cancer (BC) who have failed prior systemic therapy. Aberrant activation of the Ras/Raf/MEK/ERK pathway occurs in more than 60% of BC indicating the importance of this pathway in biliary carcinogenesis. Furthermore anti-angiogenic agents such as the VEGF-antagonist bevacizumab, and the multikinase inhibitor sorafenib have been tested in BC in the first line setting with modest activity. Regorafenib is an oral multi-kinase inhibitor that targets multiple membrane-bound and intracellular kinases including VEGF, the Ras/Raf/MEK/ERK and PDGFR- ß pathways. Given the pivotal role of these pathways in biliary cancer biology, the clinical evaluation of regorafenib represents a novel and rational approach to treat this disease. Methods: This is a multi-institutional phase II single arm single-stage design trial using regorafenib as single agent. Patients with histologically or cytologically-proven locally advanced or metastatic biliary tract carcinomas that failed no more than 2 prior line of systemic chemotherapy are eligible for this study. Patients must have measurable disease per RECIST 1.1 criteria and never been treated with VEGF inhibitors. Patients will receive regorafenib 160 mg daily (21 days on and 7 days off) and will be evaluated for response every 2 cycles (1cycle = 28 days). The study’s primary endpoint is 6 month overall survival. Secondary endpoints are to define disease control, progression-free survival and toxicity related to treatment. Correlative biomarker studies using plasma samples will be performed to investigate levels of 40 relevant proteins associated with the above-mentioned pathways in the attempt to identify predictive markers of drug benefit. As per September 2015, twelve of the 39 planned patients have been accrued for the study. In addition to Moffitt Cancer Center, this trial will enroll patients at the UNC Lineberger Comprehensive Cancer Center and VCU Massey Cancer Center. Clinical trial information: NCT02115542.

scholarly journals Feasibility of Intensity-Modulated and Image-Guided Radiotherapy for Functional Organ Preservation in Locally Advanced Laryngeal Cancer

PLoS ONE ◽  
2012 ◽  
Vol 7 (8) ◽  
pp. e42729 ◽  
Author(s):  
Nam P. Nguyen ◽  
Alexander Chi ◽  
Michael Betz ◽  
Fabio Almeida ◽  
Paul Vos ◽  
...  
Keyword(s):  
Laryngeal Cancer ◽  
Organ Preservation ◽  
Locally Advanced ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
Intensity Modulated

scholarly journals Principles of radiotherapy for laryngeal cancer

2021 ◽  
Vol 11 (1) ◽  
pp. 24-33
Author(s):  
S. B. Alieva ◽  
R. I. Azizyan ◽  
A. M. Mudunov ◽  
I. A. Zaderenko ◽  
N. A. Daykhes ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Laryngeal Cancer ◽  
Organ Preservation ◽  
Locally Advanced ◽  
Specific Method ◽  
Linear Electron ◽  
Electron Accelerators ◽  
Laryngeal Tumors ◽  
Advanced Stages ◽  
Modern Technologies

Radiation therapy as one of the main specific method of treatment is widely used to treat patients with laryngeal cancer. Currently, the main radiotherapy technique for the treatment of patients with head and neck cancer is linear electron accelerators that can provide individual, complex configurations of radiation volumes. The article presents new modern technologies of radiation therapy in the early and locally-advanced stages of the disease, principles of organ-preservation treatment in laryngeal tumors, indications for pre-and postoperative radiation, methods of prevention of post-therapeutic complications.

scholarly journals Organ preservation surgery in patients with locally advanced laryngeal cancer

2019 ◽  
Vol 100 (3) ◽  
pp. 511-515
Author(s):  
P V Svetitskiy ◽  
V L Volkova ◽  
I V Aedinova
Keyword(s):  
Laryngeal Cancer ◽  
Organ Preservation ◽  
Radiation Treatment ◽  
Skin Flap ◽  
Thyroid Cartilage ◽  
Locally Advanced ◽  
Cancer Stage ◽  
Antiseptic Solution ◽  
Results Of Treatment ◽  
Healthy Mucosa

Aim. To improve the results of treatment of patients with locally advanced laryngeal cancer by developing organ preservation surgery combined with radiation therapy. Methods. 20 patients with locally advanced laryngeal cancer stage III (T3N0-1M0) were examined. A surgery was developed that involves lateral resection of the larynx in conjunction with the underlying thyroid cartilage, preserving its upper 1/3-1/4 portion as a horizontal plate not affected by a tumor. On the affected side of the neck, a skin flap is preliminarily harvested, by 1.5-1.0 cm longer and wider than the resulting laryngeal defect. It is put over the fragment of thyroid cartilage left after resection and sutured to the healthy mucosa of the preserved part of the larynx. Laryngostomy and tracheostomy are formed. Tracheostomy tube is inserted. Formed laryngostomy is freely tamponed with two to three tampons with an antiseptic solution for up to 7 days. Naso-esophageal probe is inserted. Patients who did not receive radiation treatment before surgery, receive postoperative gamma-therapy after 14-20 days with cumulative dose up to 40 Gy. Plastic surgery of laryngostomy and tracheostomy is performed after 4-5 months after the intervention. Results. The developed method of surgery for patients with stage 3 of one half of the larynx allowed a radical removal of the tumor with the restoration of breathing, swallowing and speech. The event-free 5-year survival rate was 80±4.5%, and the total 3-year survival was 100%. Сonclusion. The developed technique of organ-preserving surgery in patients with locally advanced laryngeal cancer stage 3 involving its one half can provide oncological radical technique with the rehabilitation of the functions of the larynx.

Circulating Tumor DNA Profiling of Advanced Biliary Tract Cancers

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Kabir Mody ◽  
Pashtoon M. Kasi ◽  
JuDong Yang ◽  
Phani Keerthi Surapaneni ◽  
Tanios Bekaii-Saab ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Locally Advanced ◽  
Circulating Tumor Dna ◽  
Comprehensive Cancer Center ◽  
Molecular Diagnostic ◽  
Cancer Center ◽  
Biliary Tract Cancers ◽  
Variants Of Unknown Significance ◽  
Unknown Significance ◽  
Tumor Dna

PURPOSE Recent advances in molecular diagnostic technologies have allowed for the evaluation of solid tumor malignancies via noninvasive blood sampling, including circulating tumor DNA (ctDNA) profiling. We sought to characterize the ctDNA genomic alteration landscape in patients with biliary tract cancers (BTCs). PATIENTS AND METHODS From January 2015 to February 2018, 124 patients with BTC at the Mayo Clinic Comprehensive Cancer Center underwent ctDNA testing using a clinically available assay. The majority of samples (n = 122) were tested using the 73-gene panel that includes somatic genomic targets, including complete or critical exon coverage in 30 and 40 genes, respectively, and in some, amplifications, fusions, and indels. RESULTS A total of 138 samples were included, with approximately 70% of patients having intrahepatic BTC. All patients had locally advanced or metastatic BTC. Samples with one or more alterations, when variants of unknown significance were excluded, numbered 105 (76%). Each sample contained, on average, three alterations with a median allelic fraction of 0.52%. The overall landscape of alterations is summarized in Figures 1 and 2. After excluding variants of unknown significance, therapeutically relevant alterations were observed in 76 patients (55%), including BRAF mutations, ERBB2 amplifications, FGFR2 fusions, FGFR2 mutations, and IDH1 mutations seen in 21% of patients. A different spectrum of alterations was observed in patients with early-onset BTC (younger than age 50 years) compared with older patients (older than age 50 years). CONCLUSION Data on ctDNA in BTC is currently limited. Our study, the largest cohort reported to date to our knowledge, demonstrates the feasibility of ctDNA testing in this disease. We provide a foundation upon which the field can continue to grow.

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