Is Delivery of Aerosolized Medication via HFNC for Critical Asthma Effective Concurrent Therapy?

2021 ◽  
Vol 66 (8) ◽  
pp. 1366-1367
Author(s):  
Natalie Napolitano
Keyword(s):  
Author(s):  
William D. Ewing ◽  
Jessica Rohlfing Pryor
Keyword(s):  

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2089-2089 ◽  
Author(s):  
Mark Kirschbaum ◽  
Ivana Gojo ◽  
Stuart L. Goldberg ◽  
Lisa Kujawski ◽  
Ehab Atallah ◽  
...  

Abstract Abstract 2089 Poster Board II-66 Introduction: Although the introduction of epigenetic therapies, such as the DNA methyltransferase inhibitor (DNMT) decitabine, has improved options for the treatment of myeloid malignancies, use is limited by sub-optimal response rates. Therefore, there remains a need for more effective treatment strategies to improve outcomes in AML/MDS. Preclinical and clinical data suggest that broadening epigenetic targeting by adding histone deacetylase (HDAC) inhibitors to DNMTs may improve responses. In addition, it has been reported that outcomes may differ according to the sequence in which HDAC and DNMT inhibitors are combined. Aim: Here we present preliminary data from a Phase I, open-label, multicenter, dose-escalating study, designed to determine the maximum-tolerated dose (MTD) and recommended Phase II dose of the HDAC inhibitor vorinostat combined either concurrently or sequentially with decitabine in patients (pts) with AML/MDS. Other endpoints include tolerability and exploratory assessments of activity. Methods: Pts (≥18 years) with intermediate-high risk MDS, relapsed/refractory AML, or untreated AML (≥60 years; unsuitable for standard chemotherapy), with an ECOG performance status of ≤2, were enrolled into one of six dosing levels (Table) and received treatment for up to 24 months or until disease progression (PD). Results: As of August 3, 2009, 72 pts have entered the study: median age was 68 years (range 18-85) and 58% were male. To date, 69 pts have discontinued due to PD/lack of efficacy (n=37), withdrawal of consent (n=12), adverse events (AEs) (n=16), physician decision (n=3), and protocol deviation (n=1). Of 70 pts evaluable for safety, 69 experienced AEs, the majority of which were Grade 1/2 in severity and included nausea (n=48), diarrhea (n=41), fatigue (n=36), constipation (n=32), and vomiting (n=28). 62 (89%) pts experienced treatment-related AEs and 17 (24%) pts experienced treatment-related serious AEs. 14 deaths occurred during the study, although none were related to study treatment. One dose-limiting toxicity, prolonged QT interval, was documented in dose level 3a. Combinations of vorinostat and decitabine in the schedules in this protocol did not reach MTD. As per protocol, dose levels 3 and 3a were the maximum administered doses and have been expanded. Of the 61 pts evaluable for response, 11 had MDS, 25 had relapsed/refractory AML, and 25 had untreated AML. In pts with MDS receiving concurrent therapy (n=5), complete remission (CR) was achieved in 2 pts, stable disease (SD) in 1 pt, partial remission (PR) in 1 pt, hematologic improvement (HI) in 1 pt; all 6 of the pts who received sequential treatment experienced SD. In pts with relapsed/refractory AML receiving concurrent therapy (n=12), CR was achieved in 1 pt, CR without recovery of counts (CRi) in 1 pt, HI in 1 pt, SD in 6 pts, while 3 pts had PD; in those receiving sequential therapy (n=13), SD was achieved in 9 pts while 4 had PD. In pts with untreated AML receiving concurrent therapy (n=12), CR was achieved in 4 pts, CRi in 1 pt, PR in 1 pt, and SD in 6 pts, and in those receiving sequential therapy (n=13), CR was achieved in 2 pts, CRi in 2 pts, PR in 1 pt, HI in 2 pts, and SD in 5 pts. Overall, CR or CRi was achieved by 18% pts with MDS, 8% with relapsed/refractory AML, and 36% with untreated AML; and HI was reported in 9% pts with MDS, 4% with relapsed/refractory AML, and 8% with untreated AML. Conclusion: These preliminary data indicate that the combination of vorinostat with decitabine, either concurrently or sequentially, is possible without significant toxicity. In addition, the combination shows promising activity in MDS and untreated AML. Disclosures: Kirschbaum: Merck: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Celegene: Speakers Bureau; Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Off Label Use: Vorinostat is a histone deacetylase (HDAC) inhibitor that was approved in the FDA in October 2006 for the treatment of cutaneous manifestations in patients with cutaneous T-cell lymphoma (CTCL) who have progressive, persistent, or recurrent disease on or following two systemic therapies. Goldberg:Merck: Research Funding. Marks:Merck: Research Funding. Di Gravio:Merck: Employment, Equity Ownership. Pyle:Merck: Employment, Equity Ownership. Rizvi:Merck: Employment, Equity Ownership. Issa:Eisai: Consultancy, Research Funding; Celegene: Research Funding; MGI Pharma: Research Funding.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 582-582
Author(s):  
D. N. Church ◽  
M. Flubacher ◽  
A. Cameron ◽  
A. Bahl ◽  
J. Braybrooke

582 Background: In the adjuvant management of breast cancer although delivery of radiotherapy (RT) concurrently with anthracyclines is contraindicated, toxicities are acceptable when the chemotherapy regimen used is CMF. The NEAT trial (NEJM 2006; 355:1851- 1862), presented at ASCO in 2003 demonstrated a significant survival advantage for sequential 4x epirubicin and 4x CMF chemotherapy (E- CMF) compared with 6x CMF and was adopted in the UK as a standard regimen. In order to limit treatment duration, RT may be given concurrently with chemotherapy during the CMF phase of treatment. We have reviewed the toxicity associated with this approach. Methods: Retrospective review of all patients treated with concurrent breast RT and CMF chemotherapy as part of the E-CMF regimen in our institution. Toxicities were graded according to the Radiation Therapy Oncology Group (RTOG) toxicity criteria. Confidence intervals were calculated by the binomial method using Stata version 9. Results: 77 patients received concurrent therapy between March 2004 and May 2006. Baseline characteristics; median age: 48, ER positive: 63.5%, HER2 positive: 11.7%, node positive disease: 85.7%. Type of surgery; lumpectomy: 61.0%, mastectomy: 39.0%, nodal dissection: 100%. Chemotherapy delivery; completed without delay: 35.1%, completed therapy with dose reduction/delay: 48.1%, discontinued therapy prematurely due to toxicity 16.8%. Sites of RT; breast: 62.3%, chest wall: 35.1%, axillary nodes: 45.5%, supraclavicular fossa: 36.4%. Schedule of RT; 50Gy/25#: 18.2%, 46/45Gy/20#: 67.6%, 45Gy/15#: 14.3%. Median interval between final dose of epirubicin and start of RT: 55 days. Toxicity; cutaneous grade 3–4 acute radiotherapy toxicity: 31.2% (95%CI 21.1–42.7%); cutaneous infective cellulitis: 14.3% (95%CI 7.4–21.1%); grade 3–4 neutropenia: 54.4% (95%CI 42.8–65.9%); febrile neutropenia requiring hospitalisation: 22.1% (95% CI 13.4–33.0%). The median duration of stay in hospitalised patients was 8 days (range 3–23 days). Conclusions: Toxicities were significantly greater than documented previously for concurrent therapy. RT should not be given concurrently with CMF chemotherapy as part of the E-CMF regimen. No significant financial relationships to disclose.


Phytomedicine ◽  
2011 ◽  
Vol 18 (2-3) ◽  
pp. 151-157 ◽  
Author(s):  
J. Eisenbraun ◽  
R. Scheer ◽  
M. Kröz ◽  
F. Schad ◽  
R. Huber

2019 ◽  
Vol 24 (9) ◽  
pp. 452-457
Author(s):  
Sue Paterson

Ectoparasite control forms an important part of any routine canine health programme but is also an integral part of the management of pruritic skin disease in the dog. As such it is important that veterinary surgeons are aware of the life cycle of the flea and the mode of action of the numerous flea control products that are currently available. The suitability of a product may be different depending on the health status of the dog and concurrent therapy. This article considers the most important groups of flea control products.


2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 4152-4152
Author(s):  
Y. Rino ◽  
T. Imada ◽  
Y. Takanashi

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