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[PMID]:29390436
[Au] Autor:Jiang S; Wang G; Dong Y
[Ad] Endereço:Department of Medical Oncology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
[Ti] Título:Endostar combined with chemotherapy in a pediatric osteosarcoma with pulmonary metastasis and malignant pleural effusion: A case report.
[So] Source:Medicine (Baltimore);96(51):e9077, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Angiogenesis is a key factor for tumor growth and metastasis both in cancer and sarcoma. Endostar, a novel safe and well-tolerated recombinant human endostatin, can suppress the expression of VEGF and the activation of ERK, MAPK, and AKT, and then inhibit tumor progression. PATIENT CONCERNS: A pediatric osteosarcoma with pulmonary metastasis and malignant pleural effusion. DIAGNOSES: Osteosarcoma with pulmonary metastasis and malignant pleural effusion. INTERVENTIONS: Considering the physical condition of patient, the patient underwent surgical resection of the right lung lesion after receiving endostar combined with chemotherapy and maintained endostar alone for 47 cycles. OUTCOMES: The patient obtained pathologic complete remission and had been in progression-free survival up to now. LESSONS: Our experience could provide a treatment strategy for pediatric osteosarcoma patients with pulmonary metastasis and malignant pleural effusion.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias Ósseas/tratamento farmacológico
Endostatinas/administração & dosagem
Neoplasias Pulmonares/tratamento farmacológico
Neoplasias Pulmonares/secundário
Osteossarcoma/tratamento farmacológico
[Mh] Termos MeSH secundário: Neoplasias Ósseas/patologia
Criança
Etoposídeo/administração & dosagem
Seres Humanos
Ifosfamida/administração & dosagem
Neoplasias Pulmonares/cirurgia
Osteossarcoma/patologia
Osteossarcoma/secundário
Osteossarcoma/cirurgia
Derrame Pleural Maligno/tratamento farmacológico
Derrame Pleural Maligno/etiologia
Derrame Pleural Maligno/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Endostatins); 0 (endostar protein); 6PLQ3CP4P3 (Etoposide); UM20QQM95Y (Ifosfamide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009077


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[PMID]:29209924
[Au] Autor:Oosten LEM; Chamuleau MED; Thielen FW; de Wreede LC; Siemes C; Doorduijn JK; Smeekes OS; Kersten MJ; Hardi L; Baars JW; Demandt AMP; Stevens WBC; Nijland M; van Imhoff GW; Brouwer R; Uyl-de Groot CA; Kluin PM; de Jong D; Veelken H
[Ad] Endereço:Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. l.e.m.oosten@lumc.nl.
[Ti] Título:Treatment of sporadic Burkitt lymphoma in adults, a retrospective comparison of four treatment regimens.
[So] Source:Ann Hematol;97(2):255-266, 2018 Feb.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Burkitt lymphoma is an aggressive B cell malignancy accounting for 1-2% of all adult lymphomas. Treatment with dose-intensive, multi-agent chemotherapy is effective but associated with considerable toxicity. In this observational study, we compared real-world efficacy, toxicity, and costs of four frequently employed treatment strategies for Burkitt lymphoma: the Lymphome Malins B (LMB), the Berlin-Frankfurt-Münster (BFM), the HOVON, and the CODOX-M/IVAC regimens. We collected data from 147 adult patients treated in eight referral centers. Following central pathology assessment, 105 of these cases were accepted as Burkitt lymphoma, resulting in the following treatment groups: LMB 36 patients, BFM 19 patients, HOVON 29 patients, and CODOX-M/IVAC 21 patients (median age 39 years, range 14-74; mean duration of follow-up 47 months). There was no significant difference between age, sex ratio, disease stage, or percentage HIV-positive patients between the treatment groups. Five-year progression-free survival (69%, p = 0.966) and 5-year overall survival (69%, p = 0.981) were comparable for all treatment groups. Treatment-related toxicity was also comparable with only hepatotoxicity seen more frequently in the CODOX/M-IVAC group (p = 0.004). Costs were determined by the number of rituximab gifts and the number of inpatients days. Overall, CODOX-M/IVAC had the most beneficial profile with regards to costs, treatment duration, and percentage of patients completing planned treatment. We conclude that the four treatment protocols for Burkitt lymphoma yield nearly identical results with regards to efficacy and safety but differ in treatment duration and costs. These differences may help guide future choice of treatment.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Linfoma de Burkitt/tratamento farmacológico
Análise Custo-Benefício
Infecções por HIV/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Linfoma de Burkitt/complicações
Linfoma de Burkitt/economia
Linfoma de Burkitt/mortalidade
Carmustina/economia
Carmustina/uso terapêutico
Ciclofosfamida/economia
Ciclofosfamida/uso terapêutico
Citarabina/economia
Citarabina/uso terapêutico
Etoposídeo/economia
Etoposídeo/uso terapêutico
Feminino
Infecções por HIV/complicações
Infecções por HIV/economia
Infecções por HIV/mortalidade
Seres Humanos
Ifosfamida/economia
Ifosfamida/uso terapêutico
Masculino
Melfalan/economia
Melfalan/uso terapêutico
Metotrexato/economia
Metotrexato/uso terapêutico
Meia-Idade
Estadiamento de Neoplasias
Estudos Retrospectivos
Rituximab/economia
Rituximab/uso terapêutico
Análise de Sobrevida
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
04079A1RDZ (Cytarabine); 4F4X42SYQ6 (Rituximab); 6PLQ3CP4P3 (Etoposide); 8N3DW7272P (Cyclophosphamide); Q41OR9510P (Melphalan); U68WG3173Y (Carmustine); UM20QQM95Y (Ifosfamide); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3167-7


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[PMID]:28452030
[Au] Autor:Lai WW; Chuang YC; Lin AY
[Ad] Endereço:Graduate Institute of Environmental Engineering, National Taiwan University, 71 Chou-shan Road, Taipei, 106, Taiwan.
[Ti] Título:The effects and the toxicity increases caused by bicarbonate, chloride, and other water components during the UV/TiO degradation of oxazaphosphorine drugs.
[So] Source:Environ Sci Pollut Res Int;24(17):14595-14604, 2017 Jun.
[Is] ISSN:1614-7499
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The influences of HCO , Cl , and other components on the UV/TiO degradation of the antineoplastic agents ifosfamide (IFO) and cyclophosphamide (CP) were studied in this work. The results indicated that the presence of HCO , Cl , NO , and SO in water bodies resulted in lower degradation efficiencies. The half-lives of IFO and CP were 1.2 and 1.1 min and increased 2.3-7.3 and 3.2-6.3 times, respectively, in the presence of the four anions (initial compound concentration = 100 µg/L, TiO loading =100 mg/L, anion concentration = 1000 mg/L, and pH = 8). Although the presence of HCO in the UV/TiO /HCO system resulted in a lower degradation rate and less byproduct formation for IFO and CP, two newly identified byproducts, P11 (M.W. = 197) and P12 (M.W. = 101), were formed and detected, suggesting that additional pathways occurred during the reaction of •CO in the system. The results also showed that •CO likely induces a preferred ketonization pathway. Besides the inorganic anions HCO , Cl , NO , and SO , the existence of dissolved organic matter in the water has a significant effect and inhibits CP degradation. Toxicity tests showed that higher toxicity occurred in the presence of HCO or Cl during UV/TiO treatment and within 6 h of reaction time, implying that the effects of these two anions should not be ignored when photocatalytic treatment is applied to treat real wastewater.
[Mh] Termos MeSH primário: Antineoplásicos/química
Bicarbonatos
Ciclofosfamida/química
Ifosfamida/química
Titânio
[Mh] Termos MeSH secundário: Antineoplásicos/toxicidade
Ciclofosfamida/toxicidade
Ifosfamida/toxicidade
Oxirredução
Raios Ultravioleta
Águas Residuais
Água
Poluentes Químicos da Água
Purificação da Água
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Bicarbonates); 0 (Waste Water); 0 (Water Pollutants, Chemical); 059QF0KO0R (Water); 15FIX9V2JP (titanium dioxide); 8N3DW7272P (Cyclophosphamide); D1JT611TNE (Titanium); UM20QQM95Y (Ifosfamide)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1007/s11356-017-9005-6


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[PMID]:29061820
[Au] Autor:Opydo-Chanek M; Sladowska K; Blicharski K; Mikes J; Fedorocko P; Niemeyer U; Mazur L
[Ad] Endereço:Department of Experimental Hematology, Jagiellonian University in Krakow, Krakow, Poland.
[Ti] Título:Comparison of Antileukemic Activity of 4-Hydroperoxyifosfamide and 4-Hydroperoxycyclophosphamide.
[So] Source:Anticancer Res;37(11):6355-6361, 2017 11.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIM: The oxazaphosphorines, ifosfamide and cyclophosphamide, represent a class of alkylating agents. The aim of the present in vitro study was to compare antileukemic activity of 4-hydroperoxyifosfamide (4-OOH-IF) and 4-hydroperoxycyclophosphamide (4-OOH-CP). MATERIALS AND METHODS: The experiments were performed on MOLT-4 and ML-1 cells. The research was conducted using flow cytometry fluorescein diacetate/propidium iodide (PI), fluorescein-conjugated annexin V/PI, CaspGLOW Red Active Caspase-8 and -9, CellEvent™ Caspase-3/7 Green assays, and tetramethylrhodamine ethyl ester test. RESULTS: 4-OOH-IF and 4-OOH-CP distinctly reduced cell viability and triggered apoptosis and necrosis, causing changes in intracellular esterase activity, plasma membrane structure and integrity, caspase activation, and mitochondrial membrane potential. The oxazaphosphorines were responsible for the different antileukemic activities. 4-Hydroperoxyifosfamide appeared to be less cytotoxic against the leukemia cells than 4-hydroperoxycyclophosphamide. MOLT-4 cells were more sensitive to the action of the oxazaphosphorines than ML-1 cells. CONCLUSION: The findings provide a new insight on the mechanisms of cytotoxic action of 4-OOH-IF and 4-OOH-CP on the human acute lymphoblastic and myeloblastic leukemia cells.
[Mh] Termos MeSH primário: Antineoplásicos/farmacologia
Ciclofosfamida/análogos & derivados
Ifosfamida/análogos & derivados
Leucemia/metabolismo
[Mh] Termos MeSH secundário: Apoptose
Caspases/metabolismo
Linhagem Celular Tumoral
Membrana Celular/efeitos dos fármacos
Sobrevivência Celular/efeitos dos fármacos
Ciclofosfamida/farmacologia
Esterases/metabolismo
Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos
Seres Humanos
Ifosfamida/farmacologia
Leucemia/tratamento farmacológico
Potencial da Membrana Mitocondrial/efeitos dos fármacos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 39800-28-7 (hydroperoxyisophosphamide); 8N3DW7272P (Cyclophosphamide); EC 3.1.- (Esterases); EC 3.4.22.- (Caspases); U880A4FUDA (perfosfamide); UM20QQM95Y (Ifosfamide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE


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[PMID]:28953641
[Au] Autor:Yang XY; Jiang L; Jia RF; Hou AJ
[Ad] Endereço:Shanghai Xuhui District Center Hospital, Shanghai, China.
[Ti] Título:Treatment of grey zone lymphoma using the R-CODOX-M/R-IVAC protocol: Two case reports.
[So] Source:Medicine (Baltimore);96(39):e8121, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: We report our experience with 2 patients diagnosed with grey zone lymphoma (GZL). The histopathological characteristics of lymphomatous tissues in these patients ranged between those of diffuse large B-cell lymphoma (DLBCL) and the classical Hodgkin lymphoma. PATIENT CONCERNS: A 52-year-old female presented to the hospital with a history of lower abdominal pain of metastatic origin for 2 days. She was diagnosed with acute appendicitis and had undergone emergency surgery. A 17-year-old male was admitted to the hospital because of acute left upper abdomen pain. DIAGNOSES: Both patients are diagnosed of GZL primarily based on histopathology. INTERVENTIONS: Both patients were treated with R-CODOX-M/R-IVAC regimen for 4 to 6 cycles. OUTCOMES: The short-term curative effect was complete response; no recurrence was observed as of 32-month follow-up. LESSONS: R-CODOX-M/IVAC regimen exhibited relatively good curative effect. International Prognostic Index score and lactate dehydrogenase level may correlate with prognosis of these patients.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Linfoma de Células B/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Ciclofosfamida/administração & dosagem
Citarabina/administração & dosagem
Doxorrubicina/administração & dosagem
Etoposídeo/administração & dosagem
Feminino
Seres Humanos
Ifosfamida/administração & dosagem
Masculino
Metotrexato/administração & dosagem
Meia-Idade
Resultado do Tratamento
Vincristina/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
04079A1RDZ (Cytarabine); 5J49Q6B70F (Vincristine); 6PLQ3CP4P3 (Etoposide); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); UM20QQM95Y (Ifosfamide); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008121


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[PMID]:28888849
[Au] Autor:Bajpai J; Chandrasekharan A; Talreja V; Simha V; Chandrakanth MV; Rekhi B; Khurana S; Khan A; Vora T; Ghosh J; Banavali SD; Gupta S
[Ad] Endereço:Tata Memorial Hospital, Dr. E Borges Road, Parel, Mumbai, 400 012, India. Electronic address: dr_jyotibajpai@yahoo.co.in.
[Ti] Título:Outcomes in non-metastatic treatment naive extremity osteosarcoma patients treated with a novel non-high dosemethotrexate-based, dose-dense combination chemotherapy regimen 'OGS-12'.
[So] Source:Eur J Cancer;85:49-58, 2017 Nov.
[Is] ISSN:1879-0852
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: High-dose methotrexate (HDMTX)-based regimens are widely used in osteosarcoma. However, mandatory in-patient treatment with complex pharmacokinetic monitoring requirement precludes its use, especially in resource-constrained settings of low- and middle-income countries (LMICs). METHODS: All treatment naive consecutive patients of osteosarcoma were prospectively treated on a novel institutional regimen (named OGS-12) comprising of eight sequential doublets of the following drugs: doxorubicin, cisplatin and ifosfamide in four courses each, given in the neoadjuvant and adjuvant settings. Data were prospectively collected on baseline characteristics, histological response to neoadjuvant chemotherapy (NACT), toxicity, event-free survival (EFS) and overall survival (OS). RESULTS: Between 2011 and 2014, 317 treatment naive patients with extremity osteosarcoma were seen, of whom 237 (75%) were non-metastatic. Majority had high tumour burden, with mean tumour size of 10.45 cm, high serum lactate dehydrogenase (LDH) and serum alkaline phosphatase (SAP) in 71% and 88% respectively. A significant number (34%) were nutritionally challenged. Two-hundred ten of 237 patients were analysable for histological response of which 58% had good response (viable cells ≤10%). At the median follow-up of 34.31 (2-60) months, in intention-to-treat (ITT) analysis, the 5-year EFS and OS were 56% and 75% respectively; the same were 60% and 80% in per-protocol analysis. There was febrile neutropenia (FN) in 56%, grade 3/4 thrombocytopaenia in 22% and anaemia in 47% with two chemotoxic deaths. Ten percent of the patients had grade 3/4 diarrhoea and stomatitis and one patient developed grade 4 acute kidney injury requiring dialysis. Baseline SAP (per-protocol) for EFS and performance status (ITT) for OS were found to be independent variables. Histological response was an independent predictor for EFS and OS in both the analyses. CONCLUSIONS: In treatment naive patients with non-metastatic osteosarcoma, OGS-12 protocol, a dose-dense, non-HDMTX-based, novel, economic and easy to administer regimen produces comparable outcomes to international standards, with acceptable toxicity and is worthy of wider clinical application.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias Ósseas/tratamento farmacológico
Metotrexato/administração & dosagem
Osteossarcoma/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Assistência Ambulatorial
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Neoplasias Ósseas/mortalidade
Neoplasias Ósseas/patologia
Quimioterapia Adjuvante
Criança
Cisplatino/administração & dosagem
Países em Desenvolvimento
Intervalo Livre de Doença
Doxorrubicina/administração & dosagem
Feminino
Seres Humanos
Ifosfamida/administração & dosagem
Índia
Análise de Intenção de Tratamento
Estimativa de Kaplan-Meier
Masculino
Metotrexato/efeitos adversos
Meia-Idade
Terapia Neoadjuvante
Osteossarcoma/mortalidade
Osteossarcoma/patologia
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
Carga Tumoral
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
80168379AG (Doxorubicin); Q20Q21Q62J (Cisplatin); UM20QQM95Y (Ifosfamide); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170911
[St] Status:MEDLINE


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[PMID]:28621163
[Au] Autor:Setola E; Noujaim J; Benson C; Chawla S; Palmerini E; Jones RL
[Ad] Endereço:a Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS , Meldola , Italy.
[Ti] Título:Eribulin in advanced liposarcoma and leiomyosarcoma.
[So] Source:Expert Rev Anticancer Ther;17(8):717-723, 2017 Aug.
[Is] ISSN:1744-8328
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The heterogeneity of soft tissue sarcomas (STS) presents a formidable management challenge. Consequently, one of the main research goals is to define specific tailored therapy for each histological subtype and to develop a more personalised approach to treatment. The standard first line chemotherapy for advanced STS is doxorubicin, with or without ifosfamide, however, a number of different drugs are emerging as active therapies beyond first-line. Areas covered: Eribulin has recently been approved for advanced liposarcoma, after an anthracycline-containing regimen, demonstrating an overall survival (OS) advantage in liposarcoma and leiomyosarcoma in a randomised Phase III clinical trial. In this manuscript, an overview of the efficacy and safety of eribulin in STS is presented, highlighting different clinical outcomes between histological subtypes and comparing data with other effective drugs used in the treatment of sarcomas. The potential mechanisms of action of eribulin are also described, including its activity as potent microtubule-destabilizing anticancer agent, which has other antitumor biological effects. Expert commentary: Eribulin is highly effective in some STS populations and also has an acceptable toxicity profile. Further studies are required to better understand the precise mechanism of action of this agent and potential role in combination schedules.
[Mh] Termos MeSH primário: Furanos/administração & dosagem
Cetonas/administração & dosagem
Leiomiossarcoma/tratamento farmacológico
Lipossarcoma/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Antineoplásicos/administração & dosagem
Antineoplásicos/efeitos adversos
Antineoplásicos/farmacologia
Doxorrubicina/administração & dosagem
Furanos/efeitos adversos
Furanos/farmacologia
Seres Humanos
Ifosfamida/administração & dosagem
Cetonas/efeitos adversos
Cetonas/farmacologia
Leiomiossarcoma/patologia
Lipossarcoma/patologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Furans); 0 (Ketones); 80168379AG (Doxorubicin); LR24G6354G (eribulin); UM20QQM95Y (Ifosfamide)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE
[do] DOI:10.1080/14737140.2017.1344098


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[PMID]:28530852
[Au] Autor:Teepen JC; van Leeuwen FE; Tissing WJ; van Dulmen-den Broeder E; van den Heuvel-Eibrink MM; van der Pal HJ; Loonen JJ; Bresters D; Versluys B; Neggers SJCMM; Jaspers MWM; Hauptmann M; van der Heiden-van der Loo M; Visser O; Kremer LCM; Ronckers CM; DCOG LATER Study Group
[Ad] Endereço:Jop C. Teepen, Leontien C.M. Kremer, and Cécile M. Ronckers, Emma Children's Hospital/Academic Medical Center; Flora E. van Leeuwen and Michael Hauptmann, Netherlands Cancer Institute; Eline van Dulmen-den Broeder, VU University Medical Center; Helena J. van der Pal and Monique W.M. Jaspers, Academi
[Ti] Título:Long-Term Risk of Subsequent Malignant Neoplasms After Treatment of Childhood Cancer in the DCOG LATER Study Cohort: Role of Chemotherapy.
[So] Source:J Clin Oncol;35(20):2288-2298, 2017 Jul 10.
[Is] ISSN:1527-7755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose Childhood cancer survivors (CCSs) are at increased risk for subsequent malignant neoplasms (SMNs). We evaluated the long-term risk of SMNs in a well-characterized cohort of 5-year CCSs, with a particular focus on individual chemotherapeutic agents and solid cancer risk. Methods The Dutch Childhood Cancer Oncology Group-Long-Term Effects After Childhood Cancer cohort includes 6,165 5-year CCSs diagnosed between 1963 and 2001 in the Netherlands. SMNs were identified by linkages with the Netherlands Cancer Registry, the Dutch Pathology Registry, and medical chart review. We calculated standardized incidence ratios, excess absolute risks, and cumulative incidences. Multivariable Cox proportional hazard regression analyses were used to evaluate treatment-associated risks for breast cancer, sarcoma, and all solid cancers. Results After a median follow-up of 20.7 years (range, 5.0 to 49.8 years) since first diagnosis, 291 SMNs were ascertained in 261 CCSs (standardized incidence ratio, 5.2; 95% CI, 4.6 to 5.8; excess absolute risk, 20.3/10,000 person-years). Cumulative SMN incidence at 25 years after first diagnosis was 3.9% (95% CI, 3.4% to 4.6%) and did not change noticeably among CCSs treated in the 1990s compared with those treated earlier. We found dose-dependent doxorubicin-related increased risks of all solid cancers ( P < .001) and breast cancer ( P < .001). The doxorubicin-breast cancer dose response was stronger in survivors of Li-Fraumeni syndrome-associated childhood cancers (leukemia, CNS, and non-Ewing sarcoma) versus survivors of other cancers ( P = .008). In addition, cyclophosphamide was found to increase sarcoma risk in a dose-dependent manner ( P = .01). Conclusion The results strongly suggest that doxorubicin exposure in CCSs increases the risk of subsequent solid cancers and breast cancer, whereas cyclophosphamide exposure increases the risk of subsequent sarcomas. These results may inform future childhood cancer treatment protocols and SMN surveillance guidelines for CCSs.
[Mh] Termos MeSH primário: Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos
Antineoplásicos/uso terapêutico
Neoplasias da Mama/epidemiologia
Segunda Neoplasia Primária/epidemiologia
Sarcoma/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Neoplasias Ósseas/terapia
Neoplasias do Sistema Nervoso Central/terapia
Quimiorradioterapia
Criança
Pré-Escolar
Ciclofosfamida/uso terapêutico
Doxorrubicina/uso terapêutico
Feminino
Seres Humanos
Ifosfamida/uso terapêutico
Incidência
Lactente
Recém-Nascido
Leucemia/terapia
Síndrome de Li-Fraumeni/terapia
Linfoma/terapia
Masculino
Meia-Idade
Países Baixos/epidemiologia
Modelos de Riscos Proporcionais
Sistema de Registros
Medição de Risco
Sarcoma/terapia
Neoplasias de Tecidos Moles/terapia
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); UM20QQM95Y (Ifosfamide)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170523
[St] Status:MEDLINE
[do] DOI:10.1200/JCO.2016.71.6902


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[PMID]:28499583
[Au] Autor:Gronchi A; Ferrari S; Quagliuolo V; Broto JM; Pousa AL; Grignani G; Basso U; Blay JY; Tendero O; Beveridge RD; Ferraresi V; Lugowska I; Merlo DF; Fontana V; Marchesi E; Donati DM; Palassini E; Palmerini E; De Sanctis R; Morosi C; Stacchiotti S; Bagué S; Coindre JM; Dei Tos AP; Picci P; Bruzzi P; Casali PG
[Ad] Endereço:Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: alessandro.gronchi@istitutotumori.mi.it.
[Ti] Título:Histotype-tailored neoadjuvant chemotherapy versus standard chemotherapy in patients with high-risk soft-tissue sarcomas (ISG-STS 1001): an international, open-label, randomised, controlled, phase 3, multicentre trial.
[So] Source:Lancet Oncol;18(6):812-822, 2017 Jun.
[Is] ISSN:1474-5488
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Previous trials from our group suggested an overall survival benefit with five cycles of adjuvant full-dose epirubicin plus ifosfamide in localised high-risk soft-tissue sarcoma of the extremities or trunk wall, and no difference in overall survival benefit between three cycles versus five cycles of the same neoadjuvant regimen. We aimed to show the superiority of the neoadjuvant administration of histotype-tailored regimen to standard chemotherapy. METHODS: For this international, open-label, randomised, controlled, phase 3, multicentre trial, patients were enrolled from 32 hospitals in Italy, Spain, France, and Poland. Eligible patients were aged 18 years or older with localised, high-risk (high malignancy grade, 5 cm or longer in diameter, and deeply located according to the investing fascia), soft-tissue sarcoma of the extremities or trunk wall and belonging to one of five histological subtypes: high-grade myxoid liposarcoma, leiomyosarcoma, synovial sarcoma, malignant peripheral nerve sheath tumour, and undifferentiated pleomorphic sarcoma. Patients were randomly assigned (1:1) to receive three cycles of full-dose standard chemotherapy (epirubicin 60 mg/m per day [short infusion, days 1 and 2] plus ifosfamide 3 g/m per day [days 1, 2, and 3], repeated every 21 days) or histotype-tailored chemotherapy: for high-grade myxoid liposarcoma, trabectedin 1·3 mg/m via 24-h continuous infusion, repeated every 21 days; for leiomyosarcoma, gemcitabine 1800 mg/m on day 1 intravenously over 180 min plus dacarbazine 500 mg/m on day 1 intravenously over 20 min, repeated every 14 days; for synovial sarcoma, high-dose ifosfamide 14 g/m , given over 14 days via an external infusion pump, every 28 days; for malignant peripheral nerve sheath tumour, intravenous etoposide 150 mg/m per day (days 1, 2, and 3) plus intravenous ifosfamide 3 g/m per day (days 1, 2, and 3), repeated every 21 days; and for undifferentiated pleomorphic sarcoma, gemcitabine 900 mg/m on days 1 and 8 intravenously over 90 min plus docetaxel 75 mg/m on day 8 intravenously over 1 h, repeated every 21 days. Randomisation was stratified by administration of preoperative radiotherapy and by country of enrolment. Computer-generated random lists were prepared by use of permuted balanced blocks of size 4 and 6 in random sequence. An internet-based randomisation system ensured concealment of the treatment assignment until the patient had been registered into the system. No masking of treatment assignments was done. The primary endpoint was disease-free survival. The primary and safety analyses were planned in the intention-to-treat population. We did yearly futility analyses on an intention-to-treat basis. The study was registered with ClinicalTrials.gov, number NCT01710176, and with the European Union Drug Regulating Authorities Clinical Trials, number EUDRACT 2010-023484-17, and is closed to patient entry. FINDINGS: Between May 19, 2011, and May 13, 2016, 287 patients were randomly assigned to a group (145 to standard chemotherapy and 142 to histotype-tailored chemotherapy), all of whom, except one patient assigned to standard chemotherapy, were included in the efficacy analysis (97 [34%] with undifferentiated pleomorphic sarcoma; 64 [22%] with high-grade myxoid liposarcoma; 70 [24%] with synovial sarcoma; 27 [9%] with malignant peripheral nerve sheath tumour; and 28 [10%] with leiomyosarcoma). At the third futility analysis, with a median follow-up of 12·3 months (IQR 2·75-28·20), the projected disease-free survival at 46 months was 62% (95% CI 48-77) in the standard chemotherapy group and 38% (22-55) in the histotype-tailored chemotherapy group (stratified log-rank p=0·004; hazard ratio 2·00, 95% CI 1·22-3·26; p=0·006). The most common grade 3 or higher adverse events in the standard chemotherapy group (n=125) were neutropenia (107 [86%]), anaemia (24 [19%]), and thrombocytopenia (21 [17%]); the most common grade 3 or higher adverse event in the histotype-tailored chemotherapy group (n=114) was neutropenia (30 [26%]). No treatment-related deaths were reported in both groups. In agreement with the Independent Data Monitoring Committee, the study was closed to patient entry after the third futility analysis. INTERPRETATION: In a population of patients with high-risk soft-tissue sarcoma, we did not show any benefit of a neoadjuvant histotype-tailored chemotherapy regimen over the standard chemotherapy regimen. The benefit seen with the standard chemotherapy regimen suggests that this benefit might be the added value of neoadjuvant chemotherapy itself in patients with high-risk soft-tissue sarcoma. FUNDING: European Union grant (Eurosarc FP7 278472).
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neurilemoma/terapia
Sarcoma/patologia
Sarcoma/terapia
Neoplasias de Tecidos Moles/patologia
Neoplasias de Tecidos Moles/terapia
[Mh] Termos MeSH secundário: Parede Abdominal
Adolescente
Adulto
Idoso
Anemia/induzido quimicamente
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Dorso
Quimioterapia Adjuvante/métodos
Criança
Dacarbazina/administração & dosagem
Desoxicitidina/administração & dosagem
Desoxicitidina/análogos & derivados
Dioxóis/administração & dosagem
Intervalo Livre de Doença
Epirubicina/administração & dosagem
Etoposídeo/administração & dosagem
Extremidades
Seres Humanos
Ifosfamida/administração & dosagem
Leiomiossarcoma/terapia
Lipossarcoma Mixoide/terapia
Meia-Idade
Terapia Neoadjuvante/métodos
Neutropenia/induzido quimicamente
Fatores de Risco
Sarcoma Sinovial/terapia
Taxoides/administração & dosagem
Tetra-Hidroisoquinolinas/administração & dosagem
Parede Torácica
Trombocitopenia/induzido quimicamente
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Dioxoles); 0 (Taxoids); 0 (Tetrahydroisoquinolines); 0W860991D6 (Deoxycytidine); 15H5577CQD (docetaxel); 3Z8479ZZ5X (Epirubicin); 6PLQ3CP4P3 (Etoposide); 7GR28W0FJI (Dacarbazine); B76N6SBZ8R (gemcitabine); ID0YZQ2TCP (trabectedin); UM20QQM95Y (Ifosfamide)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170514
[St] Status:MEDLINE


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[PMID]:28475457
[Au] Autor:Landsburg DJ; Falkiewicz MK; Maly J; Blum KA; Howlett C; Feldman T; Mato AR; Hill BT; Li S; Medeiros LJ; Torka P; Hernandez-Ilizaliturri F; Reddy NM; Singavi A; Fenske TS; Chavez JC; Kaplan JB; Behdad A; Petrich AM; Bast MA; Vose JM; Olszewski AJ; Costa C; Lansigan F; Gerson JN; Barta SK; Calzada O; Cohen JB; Lue JK; Amengual JE; Rivera X; Persky DO; Peace DJ; Nathan S; Cassaday RD
[Ad] Endereço:Daniel J. Landsburg and Anthony R. Mato, University of Pennsylvania; James N. Gerson and Stefan K. Barta, Temple University, Philadelphia, PA; Marissa K. Falkiewicz, Robert Wood Johnson Medical School, New Brunswick; Christina Howlett, Tatyana Feldman, and Anthony R. Mato, Hackensack University Medi
[Ti] Título:Outcomes of Patients With Double-Hit Lymphoma Who Achieve First Complete Remission.
[So] Source:J Clin Oncol;35(20):2260-2267, 2017 Jul 10.
[Is] ISSN:1527-7755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose Patients with double-hit lymphoma (DHL) rarely achieve long-term survival following disease relapse. Some patients with DHL undergo consolidative autologous stem-cell transplantation (autoSCT) to reduce the risk of relapse, although the benefit of this treatment strategy is unclear. Methods Patients with DHL who achieved first complete remission following completion of front-line therapy with either rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or intensive front-line therapy, and deemed fit for autoSCT, were included. A landmark analysis was performed, with time zero defined as 3 months after completion of front-line therapy. Patients who experienced relapse before or who were not followed until that time were excluded. Results Relapse-free survival (RFS) and overall survival (OS) rates at 3 years were 80% and 87%, respectively, for all patients (n = 159). Three-year RFS and OS rates did not differ significantly for autoSCT (n = 62) versus non-autoSCT patients (n = 97), but 3-year RFS was inferior in patients who received R-CHOP compared with intensive therapy (56% v 88%; P = .002). Three-year RFS and OS did not differ significantly for patients in the R-CHOP or intensive therapy cohorts when analyzed by receipt of autoSCT. The median OS following relapse was 8.6 months. Conclusion In the largest reported series, to our knowledge, of patients with DHL to achieve first complete remission, consolidative autoSCT was not associated with improved 3-year RFS or OS. In addition, patients treated with R-CHOP experienced inferior 3-year RFS compared with those who received intensive front-line therapy. When considered in conjunction with reports of patients with newly diagnosed DHL, which demonstrate lower rates of disease response to R-CHOP compared with intensive front-line therapy, our findings further support the use of intensive front-line therapy for this patient population.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Linfoma de Células B/genética
Linfoma de Células B/terapia
Transplante de Células-Tronco
[Mh] Termos MeSH secundário: Anticorpos Monoclonais Murinos/uso terapêutico
Ciclofosfamida/uso terapêutico
Citarabina/administração & dosagem
Citarabina/uso terapêutico
Dexametasona/uso terapêutico
Intervalo Livre de Doença
Doxorrubicina/uso terapêutico
Etoposídeo/uso terapêutico
Feminino
Seres Humanos
Ifosfamida/uso terapêutico
Masculino
Metotrexato/administração & dosagem
Metotrexato/uso terapêutico
Meia-Idade
Prednisona/uso terapêutico
Proteínas Proto-Oncogênicas c-bcl-2/genética
Proteínas Proto-Oncogênicas c-bcl-6/genética
Proteínas Proto-Oncogênicas c-myc/genética
Recidiva
Indução de Remissão
Taxa de Sobrevida
Transplante Autólogo
Vincristina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Murine-Derived); 0 (BCL2 protein, human); 0 (BCL6 protein, human); 0 (Proto-Oncogene Proteins c-bcl-2); 0 (Proto-Oncogene Proteins c-bcl-6); 0 (Proto-Oncogene Proteins c-myc); 0 (R-CHOP protocol); 04079A1RDZ (Cytarabine); 5J49Q6B70F (Vincristine); 6PLQ3CP4P3 (Etoposide); 7S5I7G3JQL (Dexamethasone); 80168379AG (Doxorubicin); 8N3DW7272P (Cyclophosphamide); UM20QQM95Y (Ifosfamide); VB0R961HZT (Prednisone); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170506
[St] Status:MEDLINE
[do] DOI:10.1200/JCO.2017.72.2157



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