scholarly journals Complete response of lung metastases from rectal cancer to combination first-line therapy of S-1 and irinotecan plus bevacizumab: A case report and review of the literature

2014 ◽  
Vol 7 (5) ◽  
pp. 1455-1458 ◽  
Author(s):  
JIRO SHIMAZAKI ◽  
GYO MOTOHASHI ◽  
KIYOTAKA NISHIDA ◽  
TAKANOBU TABUCHI ◽  
HIDEYUKI UBUKATA ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Lung Metastases ◽  
Complete Response ◽  
Review Of The Literature ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

scholarly journals CEPP(B): an effective and well-tolerated regimen in poor-risk, aggressive non-Hodgkin's lymphoma

Blood ◽  
1990 ◽  
Vol 76 (7) ◽  
pp. 1293-1298 ◽  
Author(s):  
NJ Chao ◽  
SA Rosenberg ◽  
SJ Horning
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Medical Center ◽  
Palliative Therapy ◽  
Complete Response ◽  
Hodgkin's Lymphoma ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Eighty-three patients with intermediate- or high-grade non-Hodgkin's lymphoma were treated with CEPP(B) (cyclophosphamide, etoposide [VP- 16], procarbazine, and prednisone with or without bleomycin) chemotherapy at Stanford University Medical Center (Stanford, CA) from January 1982 through June 1989. Sixty-nine received CEPP(B) as second- line or subsequent therapy after relapse from previous combination chemotherapy, and 14 patients received CEPP(B) as first-line therapy. Of 75 patients evaluable for response, 30 patients (40%) achieved a complete response (CR) and 24 patients (32%) achieved a partial response (PR), providing an overall response rate of 72%. Complete responses were recorded on 21 of 61 (34%) patients with recurrent disease and 9 of the 14 patients who received CEPP(B) as first line therapy (64%). Myelosuppression was the major side effect of treatment, resulting in eight neutropenic-febrile episodes from a total of 253 courses. A single fatal toxic event occurred on a patient who developed adult respiratory distress syndrome. Overall, CEPP(B) was well- tolerated and proved to be effective palliative therapy for patients with non-Hodgkin's lymphoma after relapse. As such, CEPP(B) may be considered for cytoreduction before ablative therapy and bone marrow transplantation. CEPP(B) may also be considered for initial therapy in selected patients who cannot tolerate doxorubicin-containing regimens.

Longitudinal Evaluation of Minimal Residual Disease in Patients with Multiple Myeloma who Achieve Complete Response After First Line Therapy

2019 ◽  
Vol 19 (10) ◽  
pp. e185-e186
Author(s):  
Ioannis V. Kostopoulos ◽  
Efstathios Kastritis ◽  
Aristea-Maria Papanota ◽  
Paraskevi Micheli ◽  
Panagiotis Malandrakis ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Minimal Residual Disease ◽  
Residual Disease ◽  
Complete Response ◽  
First Line ◽  
Longitudinal Evaluation ◽  
First Line Therapy ◽  
Line Therapy ◽  
Minimal Residual

Outcomes of metastatic adrenocortical carcinoma (ACC): A 16-year single institutional experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16088-e16088
Author(s):  
Dwight Hall Owen ◽  
Sandipkumar Patel ◽  
John E Phay ◽  
Lawrence Andrew Shirley ◽  
Lawrence S Kirschner ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Systemic Therapy ◽  
Lung Metastases ◽  
Cox Proportional Hazards ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Second Line ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

e16088 Background: ACC is a rare malignancy with limited data to guide management of metastatic disease. Prior research regarding survival has focused on pts with locoregional disease, but has not offered insight into the management and outcomes of pts with metastatic disease. Methods: We retrospectively reviewed patients (pts) with metastatic ACC who were treated with systemic therapy between January 2000 and October 2016 at The Ohio State University Comprehensive Cancer Center. Kaplan-Meier and Cox proportional hazards regression models were used for survival analysis. Results: A total of 18 pts received systemic therapy for distant metastatic disease. Median age at diagnosis was 51 (range 31 – 72). Median overall survival (OS) from time of diagnosis of ACC was 15.5 months (95% CI 4.8 – 28.2), and from time of systemic treatment (ST) was 7.1 months (95% CI 3.3 – 26). A germline variant of uncertain significance in MSH2 (c.138C > G) was identified in one patient. Baseline FDG-PET scans were obtained in 11/18 pts, and demonstrated avidity in all patients. Maximum SUV ranged from 4.1 to 47.6, with a median of 15. First line therapy was etoposide, doxorubicin, cisplatin, and mitotane (EDPM) in 13/18 pts and clinical trial with IMC-A12 (IGF-1 receptor antibody) in four pts. Median duration of first line therapy was 1.8 months (95% CI 0.9 – 2.8). Survival was not statistically different for patients receiving EDPM as first or second line therapy (median OS 23.3 vs 12.0 months, p = 0.96). Additional lines of therapy included EDPM, IMC-A12, AT-101, mifepristone, OSI-906 (IGF-1R inhibitor), and nivolumab. Median lines of therapy given were 2. The presence of bone metastases (p = 0.69) or lung metastases (p = 0.21) at the time of initiation of ST was not associated with OS from ST. Conclusions: In our experience, the prognosis of pts with metastatic ACC receiving systemic therapy is poor with most pts receiving ≤ 2 lines of therapy. Patients receiving first or second line EDPM seemed to have worse outcomes than noted in previously published trials, possibly due to our patients being sicker at baseline. Metastasis to the lung or bone at initiation of ST did not impact OS.

Peritonitis as the First Presentation of Disseminated Listeriosis in a Patient on Peritoneal Dialysis—a Case Report

2017 ◽  
Vol 37 (2) ◽  
pp. 239-240 ◽  
Author(s):  
Weiwei Beckerleg ◽  
Vaibhav Keskar ◽  
Jolanta Karpinski
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Listeria Monocytogenes ◽  
Empiric Therapy ◽  
Second Line ◽  
First Line ◽  
Systemic Involvement ◽  
First Line Therapy ◽  
Line Therapy ◽  
High Index Of Suspicion

Infections with Listeria monocytogenes are uncommon but serious, with mortality rate approaching 30% in cases of systemic involvement despite first-line therapy. They are usually caused by ingestion of contaminated foods, but spontaneous infections have also been described. Listeria monocytogenes is a rare cause of peritonitis, and most of the published cases are in patients with cirrhosis and ascites. There are a few reported cases of Listeria peritonitis associated with peritoneal dialysis (PD), primarily isolated peritonitis. If detected early, Listeria peritonitis can be successfully treated with ampicillin, alone or in combination with gentamicin. Vancomycin has been listed as a second-line agent. However, it has been associated with treatment failure. In this case report, we present a patient who developed disseminated listeriosis, with peritonitis as the first manifestation of disseminated infection. This case illustrates the importance of having a high index of suspicion for L. monocytogenes if patients deteriorate despite empiric therapy for PD-associated peritonitis and serves as a further example demonstrating the inadequate coverage of vancomycin for L. monocytogenes.

Non Predictive Value of An Initial Tc-99m-MIBI Scintigraphy On the Prediction of Therapeutic Outcome in Non Hodgkin and Hodgkin Lymphoma: Preliminary Results of a Prospective Study in 81 Patients.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4762-4762
Author(s):  
Marie-Pierre Gourin ◽  
Jacques Monteil ◽  
Benoit Marin ◽  
Stéphane Girault ◽  
Natalya Dmytruk ◽  
...  
Keyword(s):  
Prospective Study ◽  
Predictive Value ◽  
Complete Response ◽  
Therapeutic Outcome ◽  
Response To Treatment ◽  
High Grade ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Mibi Scintigraphy

Abstract Abstract 4762 Introduction Tc-99m-MIBI, a radioactive tracer used in routine to explore myocardial perfusion, parathyroids or in oncology for high-grade glioma, has been described as a promising agent for the functional characterization of p-glyco-protein expression and the prediction of the therapeutic outcome in patients (pts) with Hodgkin (HL) and non-Hodgkin's lymphoma (NHL)( Liang LA, 2001; Kao CH 2002). As resistance to chemotherapy is the major cause of treatment failure in NHL, the goal of treatment is to avoid an incomplete response after first line chemotherapy. This prospective study was designed to investigate the relationship between uptake by Tc-99m-MIBI scintigraphy and response to treatment in aggressive and follicular NHL, and HL. Patients and Methods Study protocol was a monocentric prospective study conducted between 10/2005 and 11/2008. Inclusion criteria included untreated pts with a histological diagnosis of HL or high grade NHL or follicular (FL) and managed in a hematological regional care network: HEMATOLIM, aged 18 years and more, with an initial and final assessment by a CT scan and/or TEP scan and with an informed consent. Were excluded pregnant or lactating women, pts without social security coverage or with initial corticosteroids. During the initial assessment, a Tc-99m-MIBI was performed with an injection of 20 mCi of tracer before any therapeutics. Images were obtained 10 minutes after intra-venous injection of Tc-MIBI. The rate of complete response (CR) and incomplete response (IR) at the end of first line therapy was evaluated with and compared with MIBI uptake. Results The study included 81pts, sex ratio 1.61, median age 55 years (18-84)with an histological diagnosis of HL 41.9% (n=34), FL 9.9% (n=8), and aggressive NHL 48.2% (n=39) including DLBCL 38.3% (n=31), T cell NHL 4.9% (n=4), NK cell NHL 2.5% (n=2) and MCL 2.5% (n=2). Stade Ann Arbor I 6.2% (n=5), II 43.2% (n=35), III 12.3% (n=10) and IV 38.3% (n=31). Performans status were 0 for 51.85% (n=42), 1 for 35.8% (n=29), 2 for 11.11% (n=9) and 3 for 1.24% (n=1). LDH rate were increased 28.4% (n=23), normal 69.1% (n=56) and missing 2.5% (n=2). PSS for HL was favorable 41.18% (n=14), intermediate 47.06 (n=16) and unfavorable 11.76% (n=4). FLIPI score for FL was favorable 25% (n=2), intermediate for 62.5% (n=5) and non favorable for 12.5% (n=1). IPIa score was 0 for 29.03% (n=9), 1 for 32.26% (n=10), 2 for 19.35% (n=6) and 3 for 19.35% (n=6). All patients received chemotherapy in first line. For unfavorable pts a consolidation therapy has been added by radiotherapy 27.16% (n=22), or autologous stem cell transplantation for 8.54% (n=7). For 81 pts, MIBI results had positive uptake (MIBI+) 77.8% (n=63) and no uptake (MIBI-) 22.2% (n=18). For 75/81 pts eligible for final evaluation (6 deaths due to toxicity (n=3) or to NHL (n=3)), MIBI results showed 76% (n=57) MIBI+ and 24% (n=18) MIBI-. At the end of first line therapy, 82% of MIBI+ (n= 48/57) at diagnosis were in CR and 83% of MIBI – (15/18) were also in CR. There was no significant difference between the rate of MIBI+ and MIBI- for pts in CR by histological type. The distribution of disease localization were : thoracic (T) 59.3% (n=48), thoraco-abdominal (TA) 24.7% (n=20), abdominal (A) 13.6% (n=11), cranial 1.2% (n=1) and knee 1.2% (n=1). According to the results of MIBI, 83% of pts with a T localization were MIBI+ (n=40) versus 17% MIBI- (n=8), 70% of pts with a TA localization were MIBI+ (n=14) versus 30% MIBI- (n=6) and 63% of patients with a A localization were MIBI+ (n=7) versus 37% MIBI- (n=4). OS at 3 years is 90% and 3 years PFS is 79% with no significantly difference according to the response to MIBI. Sensitivity of MIBI is 80.77%, specificity 27.59%, positive predictive value is 66.67% and negative predictive value 44.44%. Conclusion This prospective study on 81 untreated pts with HL, and several varieties of aggressive NHL do not confirm the encouraging results previously reported by an asian study obtained on 25 pts considering Tc-99m as a useful predictive tool for chemoresistance. In our study, lack of MIBI uptake does not predict a decrease in the rate of complete response to treatment. Several explanations can be advanced: heterogeneous histology and prognostic score, small population. Disclosures: No relevant conflicts of interest to declare.

Outcome Of Hematopoietic Cell Transplantation (HCT) In Pediatric Patients With Hodgkin Lymphoma (HL): Single Institution Results From Saudi Arabia

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5530-5530
Author(s):  
Hassan A Sumaili ◽  
Asim F Belgaumi ◽  
Amani A Al-Kofide ◽  
Amal Al-Seraihy ◽  
Hassan El-Solh ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Progressive Disease ◽  
Pediatric Patients ◽  
Hematopoietic Cell Transplantation ◽  
Conflicts Of Interest ◽  
Complete Response ◽  
Allogeneic Bone ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Abstract Most pediatric patients with Hodgkin lymphoma are cured of their disease with standard combined-modality first-line therapy. Those who relapse are subjected to salvage chemo-radiotherapy, and patients who respond often undergo either autologous or allogeneic HCT, with a reported outcome ranging from 40%-60%. Variables affecting the outcome of such patients are not clearly defined. This study retrospectively reviewed the clinical characteristics and outcome of patients who underwent HCT at our institution. Between 1995 and 2012, 29 pediatric (age <14 years) patients with HL underwent HCT. This cohort included 24 boys and 5 girls. Their median ages at initial diagnosis and at HCT were 9.85 years (mean 8.85; range 3.6-13.75) and 12.18 years (mean 11.24; range 5.6-14.9), respectively. 28 patients had classic HL (23 nodular sclerosis, 3 mixed cellularity, 1 lymphocyte-depleted, and 1 lymphocyte-rich) and one patient had nodular lymphocyte-predominance HL. Ten had persistent/progressive disease following first line therapy, while 19 had relapsed following achievement of complete response (CR). For these patients median time to relapse from completion of first-line therapy was 16.9 months (mean 20.1; range 1.9-53.1). All patients received salvage chemotherapy and/or radiotherapy prior to HCT; fifteen patients achieved CR, 13 had a partial response and one had progressive disease. Two patients had allogeneic bone marrow (BM) grafts from matched-related donors, while the rest had autologous grafts (16 BM; 10 PBSC; 1 BM+PBSC) following chemotherapy-based myeloablative conditioning. Twelve patients have relapsed/progressed post-HCT at a median of 6.04 months (mean 11.8; range 1.02-71.4). Nine patients have died; eight because of disease progression and one due to sepsis post HCT. Only two patients died within the first 100 days post HCT, giving a Day-100 mortality rate of 6.8%. Two patients who relapsed after HCT were salvaged with chemo/radiotherapy and remain disease free 2.8 and 9.7 years later. The 5-year estimated overall survival (OS) from HCT for the whole cohort is 61.6%, with an event free survival (EFS) of 57.9%. Patients who had persistent/progressive disease at the end first-line therapy or relapsed <6months off therapy had a worse OS and EFS as compared to those who relapsed later (OS 42.9% v. 75.3%, p=0.047 [Taron-Ware]; EFS 41.7% v. 60.8%, p=0.052 [Taron-Ware]). The outcome of patients with relapsed/refractory HL following HCT is encouraging, as a majority of patients survive free of their lymphoma. Timing of relapse/progression remains an important prognostic factor and patients who fail early may be considered for novel therapeutic approaches. Disclosures: No relevant conflicts of interest to declare.

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