Hyponatraemia is a predictor of clinical outcome for malignant pleural mesothelioma

Size: px
Start display at page:

Download "Hyponatraemia is a predictor of clinical outcome for malignant pleural mesothelioma"

Transcription

1 Support Care Cancer (2015) 23: DOI /s ORIGINAL ARTICLE Hyponatraemia is a predictor of clinical outcome for malignant pleural mesothelioma R. Berardi M. Caramanti I. Fiordoliva F. Morgese A. Savini S. Rinaldi M. Torniai M. Tiberi C. Ferrini M. Castagnani F. Rovinelli A. Onofri S. Cascinu Received: 1 May 2014 /Accepted: 11 August 2014 /Published online: 21 August 2014 # Springer-Verlag Berlin Heidelberg 2014 Abstract Purpose Hyponatraemia is one of the most common tumourrelated electrolyte disorders. Several clinical, histological and serum factors have been found to influence prognosis, but, to date, there are no studies focusing on the prognostic role of hyponatraemia in mesothelioma. The aim of this study was to assess the prognostic role of hyponatraemia in malignant pleural mesothelioma. Methods We analysed 62 consecutive patients with histologically or cytologically proven advanced malignant pleural mesothelioma undergoing chemotherapy at our institution between January 2003 and September Results All patients received a first-line pemetrexed-based chemotherapy. A second-line chemotherapy was administered to 29 patients. The onset of hyponatraemia (serum sodium <135 meq/l) during the treatment was significantly related to a worsened median overall survival (7.93 vs months; p=0.0069). The occurrence of hyponatraemia during first-line chemotherapy (cutoff 135 and 130 meq/l) was significantly associated to a shorter median progression-free survival (p=0.0214). Results were also similar in the subgroup receiving a second-line treatment. At the multivariate analysis, including haemoglobin and sodium level at the beginning of first-line chemotherapy, age, gender, smoking habit, job exposure and performance status, only hyponatraemia was found to be an independent factor (p=0.029). Hyponatraemia was also found to be a predictive factor for both first-line chemotherapy, being R. Berardi (*): M. Caramanti : I. Fiordoliva : F. Morgese : A. Savini: S. Rinaldi : M. Torniai : M. Tiberi : C. Ferrini : M. Castagnani: F. Rovinelli : A. Onofri : S. Cascinu Medical Oncology Unit, Università Politecnica delle Marche Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I GM Lancisi G Salesi, Via Conca 71, Ancona, Italy related to poorer response to pemetrexed-based chemotherapy (p=0.047) and second-line chemotherapy (p=0.044). Conclusion Our results show that hyponatraemia might be considered a negative prognostic parameter in malignant pleural mesothelioma patients. To our knowledge, this is the first study to evaluate the association of hyponatraemia with the outcome of malignant pleural mesothelioma patients. Keywords Chemotherapy. Hyponatraemia. SIADH. Malignant pleural mesothelioma. Prognostic factor Introduction Hyponatraemia is the most common electrolyte disorder in hospitalized patients (15 50 % of hospitalizations in several surveys), although it is underestimated due to heterogeneous presentations defined by a sodium level <135 meq/l in serum. It can be classified into three levels: mild ( meq/ L), moderate ( meq/l) and severe (<125 meq/l) [1]. Depending on the severity and spread of this alteration, symptoms can vary from aspecific headache and mental impairment to confusion, nausea and vomit and, finally, to coma; however, most patients remain asymptomatic. Cancer-related hyponatraemia could adversely affect the performance status, the quality of life and the prognosis of cancer patients [2 4]. Furthermore it may delay time-critical treatments, such as systemic chemotherapy [5]. In some cases, these effects do not appear to be attributable only to the electrolyte disorders itself. In fact, above all neurological symptoms may have an adverse impact, for example increasing the risk of falls or worsening underlying diseases [3]. In cancer patients, hyponatraemia is often caused by the inappropriate antidiuretic hormone syndrome (SIADH), due to ectopic production of antidiuretic hormone, by extracellular fluid depletion or renal toxicity of chemotherapy, especially

2 622 Support Care Cancer (2015) 23: platinum-based [6]. These conditions are commonly associated with small cell lung cancer (SCLC), but not rarely with non-small cell lung cancer (NSCLC), lymphomas, gastrointestinal cancers and mesothelioma [4]. Malignant pleural mesothelioma (MPM) is a poor-prognosis tumour, with a median overall survival of 1 year [7]. Therapy is based on different combinations of chemotherapy, radical/palliative surgery and radiotherapy, with limited benefit due to the advanced stage at diagnosis and the elderly age [8]. Several clinical, histological and serum factors were found to influence prognosis in mesothelioma [9], but, to date, there are no studies focusing on the prognostic role of hyponatraemia in this tumour. However, it has been shown that a reduction in serum sodium has negative effects on hospitalization length, quality of life and prognosis, both in neoplastic and in non-neoplastic diseases [10, 11]. Treatments for hyponatraemia (Table 1) seem to improve clinical discomfort and chemotherapy response, but further research is needed to confirm these data [12]. The aim of this study was to assess the prognostic role of hyponatraemia in MPM, by examining the association between its onset during chemotherapy and overall survival (OS) and progression-free survival. Patients and methods Patient selection This study includes consecutive patients with histologically or cytologically proven advanced or metastatic MPM undergoing chemotherapy at our institution between January 2003 and September Table 1 Treatments for hyponatraemia Euvolemic or hypervolemic hyponatraemia Asymptomatic patients Remove cause-specific predisposing factors Discontinued, whenever possible, drugs note to cause hyponatraemia Fluid restriction±nacl supplementation±furosemide Symptomatic patients Saline (0.9 %) or hypertonic (3 %) saline (possible addition of loop diuretic) Selective vasopressin receptor antagonists (vaptans, i.e. tolvaptan) Demeclocycline/urea/lithium are available in some countries Hypovolemic hyponatraemia Remove cause-specific predisposing factors Isotonic (0.9 %) saline The rate of correction of sodium should not exceed 12 mmol/l/24 h. Excessively rapid correction of hyponatraemia can predispose to the development of cerebral oedema, central pontine myelinolysis, coma and death Eligibility criteria included: Age >18 years Cytological/histological evidence of MPM Locally advanced or metastatic stage No primary mesothelioma in other sites No others types of cancer We collected data regarding age, sex, smoking, asbestos exposure, staging, histology, performance status (PS) according to the Eastern Cooperative Oncology Group (ECOG) system, chemotherapy and levels of serum sodium before, during and after chemotherapy. We evaluated tumour objective response to treatments according to the modified RECIST criteria, validated by Byrne and Nowak in MPM patients [13]. Data management and statistical analysis The aim of this study was to evaluate the prognostic role of hyponatraemia in MPM. OS was defined as the time between histological diagnosis and last follow-up visit or death, while progression-free survival (PFS) was calculated from the start of first- and secondline chemotherapy treatment until the date of disease progression or death. Patients who were not reported as dead at the time of the analysis were censored at the date they were last known to be alive. Survival distribution was estimated using the Kaplan- Meier method, and differences in probability of surviving were evaluated by log-rank test. We chose a significant level of 0.05 to assess statistical significance. The Cox multivariate proportional hazard regression model was used to evaluate the effects of the prognostic factors on PFS and OS. Statistical analysis was performed using the MedCalc package (MedCalc v ). Results Patients were predominantly males (79 %), and median age at diagnosis was 68.5 years (range years). Underlying risk factors were the following: smoking (59.7 %) and asbestos exposure (66.1 %). Forty-two out of 62 patients had epithelioid malignant mesothelioma. Main clinical characteristics are summarized in Table 2. Seven patients (24.2 %) were treated with radical surgery and subsequently underwent postoperative radiotherapy alone or in combination with chemotherapy. All patients received a first-line pemetrexed-based chemotherapy (in monotherapy or combined with cisplatin or carboplatin) (Table 3). Only one patient showed a complete response (1.6 %), while we observed a partial response in nine (14.5 %) patients and a progressive disease in 23 patients

3 Support Care Cancer (2015) 23: Table 2 Patient characteristics Characteristics Number of patients (%): total number=62 (100 %) Age (22.6 %) >60 48 (77.4 %) Sex Male 49 (79 %) Female 13 (21 %) Smoking Yes 37 (59.7 %) No 25 (40.3 %) Asbestos exposure Yes 41 (66.1 %) No 21 (33.9 %) PS at diagnosis (ECOG) 0 33(53.2 %) 1 24(38.7 %) 2 4 (6.5 %) 3 1 (1.6 %) Staging Locally advanced 51 (82.3 %) Metastatic 11 (17.7 %) Histology Epithelioid 42 (67.7 %) Sarcomatoid 9 (14.5 %) Desmoplastic 1 (1.6 %) Biphasic 5 (8.1 %) Unknown 5 (8.1 %) Table 3 Type of therapies and response to treatments Characteristics Number of patients (%): total number=62 (100 %) First-line chemotherapy Carboplatin+pemetrexed 24 (38.7 %) Cisplatin+pemetrexed 16 (25.8 %) Pemetrexed 16 (25.8 %) Other 6 (9.7 %) Best response to treatment Progression 23 (37.1 %) Stable disease 18 (29 %) Partial response 9 (14.5 %) Complete response 1 (1.6 %) Not assessable 11 (17.7 %) Characteristics Number of patients (%): total number=29 (100 %) Second-line chemotherapy MMM 11 (37.9 %) Gemcitabine 9 (31 %) Pemetrexed 4 (13.8 %) Carboplatin+pemetrexed 2 (1.6 %) Other 3 (10.3 %) Best response to treatment Progression 13 (44.8 %) Stable disease 4 (13.8 %) Partial response 1 (3.4 %) Complete response 0 Not assessable 11 (37.9 %) MMM mitoxantrone/methotrexate/mitomycin (37.1 %). In 18 cases (29 %), a tumour stabilization was reported. A second-line therapy with mitoxantrone/methotrexate/mitomycin (MMM) or with gemcitabine in monotherapy or with pemetrexed alone or in combination with carboplatin (in selected cases responsive to first-line pemetrexed-based chemotherapy) was administered to 29 patients (Table 3). No complete responses were obtained. In the second-line setting, we observed one partial response, four (13.8 %) stable diseases and 13 (44.8 %) progressions. Fifteen out of 62 patients (24.2 %) received adjuvant or palliative radiotherapy. The median OS was months and the median PFS was 4.98 months (range ) after first-line chemotherapy and 3.38 months (range ) in the subgroup receiving a second-line therapy. The onset of hyponatraemia (serum sodium <135 meq/ L) during the treatment was observed in 14 patients (22.6 %), and it was significantly related to a worsened median OS (7.93 vs months; p=0.0069). Among hyponatraemic group of patients, only one had low sodium value before receiving chemotherapy. The remaining 13 patients developed hyponatraemia after 1 to 2 cycles of chemotherapy (after an average time of 1 month). With the exception of chemotherapy, no relevant concomitant medications can be related to the onset of hyponatraemia. The occurrence of hyponatraemia during first-line chemotherapy (cutoffs 135 and 130 meq/l) was significantly associated with a shorter median PFS (p=0.0214). In patients with normal serum sodium levels, the median PFS was 6.16 months; patients with hyponatraemia with serum sodium levels 135 and 130 meq/l showed a median PFS of 3.87 and 2.26 months, respectively (Table 4; Fig. 1). Treatment of hyponatraemia included saline i.v. infusion and hypertonic (3 %) saline i.v. infusion. Among hyponatraemic patients, only four (28.5 %cme) received a second-line treatment, while 17 out of 38 patients with no hyponatraemia (44.7 %) underwent a second-line chemotherapy. Results were also similar in the subgroup receiving a secondline treatment (Table 5). In this setting, the median PFS was 3.67 months in patients with normal serum sodium, 3.21 months and 1.51 months in patients with mild hyponatraemia

4 624 Support Care Cancer (2015) 23: Table 4 Prognostic value of hyponatraemia after first-line chemotherapy (total number: 62 patients) Hyponatraemia during therapy Yes 14 (22.6 %) <135 meq/l meq/l 3 No 38 (61.3 %) Unknown 10 (16.1 %) Median OS (months) (p=0.0069) 135 meq/l <135 meq/l 7.93 Median PFS (months) (p=0.0214) 135 meq/k 6.16 < meq/l meq/l 2.26 OS overall survival, PFS progression-free survival ( 135 meq/l) and severe hyponatraemia ( 130 meq/l), respectively (p=0.0386). The multivariate analysis, including haemoglobin and sodium level at the beginning of first-line chemotherapy, age, gender, smoking habit, job exposure and performance status, found only hyponatraemia to be an independent factor (p =0.029). Hyponatraemia was also foundtobeapredictivefactorbothinfirst-linechemotherapy, being related to poorer response to pemetrexedbased chemotherapy (p=0.047), and in second-line chemotherapy (p=0.044). Table 5 Prognostic value of hyponatraemia after second-line chemotherapy (total number: 29 patients) Hyponatraemia during therapy Yes 9 (31 %) <135 meq/l meq/l 1 No 14 (44.8 %) Unknown 6 (20.7 %) Median PFS (months) (p=0.0386) 135 meq/l 3.67 < meq/l meq/l 1.51 PFS progression-free survival Discussion Hyponatraemia is one of the most common electrolyte disorders associated with tumour-related conditions. Abundant literature is available for hyponatraemia in patients with no cancer conditions but very little is known about hyponatraemia in patients with cancer. The incidence of hyponatraemia varies largely (1 40 %), depending on the cancer type, clinical setting and serum sodium cutoff level [4]. Risk factors for hyponatraemia include chemotherapy or its toxicities, such as diarrhoea or vomiting, hydration and narcotic drugs [6, 14 16]. The main cause of hyponatraemia in malignancy, affecting 1 to 2 % of the entire cancer population, is SIADH which may result from ectopic production of Fig. 1 Kaplan-Meier overall survival curves for patients stratified on the basis of the serum sodium level at first-line chemotherapy (p=0.0069)

5 Support Care Cancer (2015) 23: arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) by the tumour tissue [17 19]. It is most common in patients with lung cancer (11 15 %), head and neck cancer (3 %), breast cancer and less frequent in other type of malignancies [6, 17, 19, 20]. Perks et al. first described SIADH in a patient with a MPM [21]. Hyponatraemia in cancer patients has been reported to adversely affect survival: in a prospective study on a general cancer population, Berghmans et al. found that hyponatraemic patients had an increased mortality compared to those with normal serum sodium levels [6]. Recently, another study reported a high frequency of hyponatraemia in hospitalized patients with cancer and a strong and independent association between hyponatraemia, longer length of stay and higher mortality [11]. In our group of 62 patients with mesothelioma receiving first-line treatment, 12 (19.4 %) presented hyponatraemia; in the second-line setting, hyponatraemia was detected in eight patients (27.6 %). A significant lower median OS and median PFS were observed in patients with a serum sodium level 135 meq/l compared with eunatraemic patients. Furthermore, among hyponatraemic patients, we found a worse lower median OS in the subgroup with serum sodium levels 130 meq/l. Hyponatraemia was significantly related to survival in both first-line setting and during the second-line of treatment. Our results seem to indicate that, in malignant pleural mesothelioma patients, the occurrence of hyponatraemia under chemotherapy may represent a significant factor influencing the outcome. Previous studies analysed prognostic factors in MPM patients in order to select the best therapeutic management; however, none of them evaluated the role of natraemia in predicting survival. The most important scoring systems were assessed by European Organisation for Research and Treatment of Cancer (EORTC) and Cancer and Leukemia Group B (CALGB). These scores included age, gender, performance status, histology and site of disease, as well as laboratoristic parameters such as haemoglobin, LDH levels, blood count of platelets and leucocytes. Both EORTC and CALGB systems were validated in following series of patients, and they represent, to date, the reference for prognostication in MPM [22 24]. Our findings are consistent with several studies analysing the impact of low serum sodium level on survival outcomes in patients with different cancer types, although in previous studies the cutoff points used in the definition of hyponatraemia were not homogeneous. In a systematic review of published studies, Castillo et al. found that in SCLC patients, hyponatraemia was an independent risk factor for poor outcome in six of the 13 analysed studies [4]. Furthermore, a low serum sodium level was identified as a negative prognostic factor also in patients with other malignancies, although evaluated only in a limited number of studies [25 28]. In a retrospective study of 453 SCLC patients undergoing chemotherapy, Hansen et al. demonstrated that patients with hyponatraemia at diagnosis had a lower median OS compared to eunatraemic patients. The authors also suggested that patients whose serum sodium value did not fully normalize within the first two cycles of chemotherapy had a worse prognosis than patients with hyponatraemia whose serum sodium value did [29]. Recently, Petereit et al. investigated the prognostic value of hyponatraemia in 2,100 lung cancer patients. They reported that the median survival in lung cancer with hyponatraemia was shorter compared to normonatraemic patients, and the correction of serum sodium above the level of 138 meq/l was correlated with an improved survival [30]. Again, cancer-related hyponatraemia has been hypothesized to adversely affect the response to treatment: in a recent study, hyponatraemia was reported to be a prognostic factor for short survival and a predictive factor for lack of response in metastatic renal cell cancer patients treated with cytokines [10]. Similarly, another recent study investigated the association of hyponatraemia on treatment outcome in metastatic renal cell cancer patients treated with anti-vegf and mtor-targeted agents. Hyponatraemia was found to be an independent predictor of OS, time to treatment failure and disease control rate [31]. The mechanisms underlying this resistance to treatment are not known. Conclusion In conclusion, hyponatraemia is a common condition in cancer patients. Our results show that it could be considered a negative prognostic parameter also in malignant pleural mesothelioma patients. Most of the studies have evaluated the prognostic value of hyponatraemia at baseline: in our study, we found a prognostic significance of hyponatraemia arising during chemotherapy. The early detection, monitoring and management of hyponatraemia might improve the patient s prognosis. To our knowledge, this is the first study to evaluate the association of hyponatraemia on outcome of malignant pleural mesothelioma patients. However, further investigations are needed to examine the effect of treating hyponatraemia on the outcome of cancer patients. Funding This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. Conflict of interest All authors disclose no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work or that could be perceived as prejudicing the impartiality of the research reported. The authors have full control of all primary data and do agree to allow the journal to review their data if requested.

6 626 Support Care Cancer (2015) 23: References 1. Ghali JK (2008) Mechanisms, risks, and new treatment options for hyponatremia. Cardiology 111: Sengupta A, Banerjee SN, Biswas NM, Jash D, Saha K, Maji A, Bandyopadhyaya A, Agarwal S (2013) The incidence of hyponatraemia and its effect on the ECOG performance status among lung cancer patients. J Clin Diagn 7: Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G (2006) Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med 119:71 e1 71 e8 4. Castillo JJ, Vincent M, Justice E (2012) Diagnosis and management of hyponatremia in cancer patients. Oncologist 17: Petereit C, Zaba O, Teber I, Lüders H, Grohé C (2013) A rapid and efficient way to manage hyponatremia in patients with SIADH and small cell lung cancer: treatment with tolvaptan. BMC Pulm Med 29: Berghmans T, Paesmans M, Body JJ (1999) A prospective study on hyponatraemia in medical cancer patients: epidemiology, aetiology and differential diagnosis. Support Care Cancer 8: Vogelzang NJ, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, Gatzemeier U, Boyer M et al (2003) Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 21: Weder W, Opitz I (2012) Multimodality therapy for malignant pleural mesothelioma. Ann Cardiothorac Surg 1: Pass HI (2012) Biomarkers and prognostic factors for mesothelioma. Ann Cardiothorac Surg 1: Jeppesen AN, Jensen HK, Donskov F, Marcussen N, von der Maase H (2010) Hyponatremia as a prognostic and predictive factor in metastatic renal cell carcinoma. Br J Cancer 102: Doshi SM, Shah P, Lei X, Lahoti A, Salahudeen AK (2012) Hyponatremia in hospitalized cancer patients and its impact on clinical outcomes. Am J Kidney Dis 59: Waikar SS, Mount DB, Curhan GC (2009) Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med 122: Byrne MJ, Nowak AK (2004) Modified RECIST criteria for assessment of response in malignant pleural mesothelioma. Ann Oncol 15: Berghmans T (1996) Hyponatremia related to medical anticancer treatment. Support Care Cancer 4: Bissett D, Cornford EJ, Sokal M (1989) Hyponatraemia following cisplatin chemotherapy. Acta Oncol 28: Gill G, Huda B, Boyd A, Skagen K, Wile D, Watson I, van Heyningen C (2006) Characteristics and mortality of severe hyponatraemia a hospital-based study. Clin Endocrinol (Oxf) 65: Sørensen JB, Andersen MK, Hansen HH (1995) Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in malignant disease. J Intern Med 238: Silverman P, Distelhorst CW (1989) Metabolic emergencies in clinical oncology. Semin Oncol 16: Talmi YP, Hoffman HT, McCabe BF (1992) Syndrome of inappropriate secretion of arginine vasopressin in patients with cancer of the head and neck. Ann Otol Rhinol Laryngol 101: Baylis PH (2003) The syndrome of inappropriate antidiuretic hormone secretion. Int J Biochem Cell Biol 35: Perks WH, Crow JC, Green M (1978) Mesothelioma associated with the syndrome of inappropriate secretion of antidiuretic hormone. Am Rev Respir Dis 117: Curran D, Sahmoud T, Therasse P, van Meerbeeck J, Postmus PE, Giaccone G (1998) Prognostic factors in patients with pleural mesothelioma: the European Organization for Research and Treatment of Cancer experience. J Clin Oncol 16: Herndon JE, Green MR, Chahinian AP, Corson JM, Suzuki Y, Vogelzang NJ (1998) Factors predictive of survival among 337 patients with mesothelioma treated between 1984 and 1994 by the Cancer and Leukemia Group B. Chest 113: Edwards JG, Abrams KR, Leverment JN, Spyt TJ, Waller DA, O Byrne KJ (2000) Prognostic factors for malignant mesothelioma in 142 patients: validation of CALGB and EORTC prognostic scoring systems. Thorax 55: Vasudev NS, Brown JE, Brown SR, Rafiq R, Morgan R, Patel PM, O Donnell D, Harnden P, Rogers M, Cocks K et al (2008) Prognostic factors in renal cell carcinoma: association of preoperative sodium concentration with survival. Clin Cancer Res 14: Kim HS, Yi SY, Jun HJ, Lee J, Park JO, Park YS, Jang J, Kim HJ, Ko Y, Lim HY, Kang WK (2007) Clinical outcome of gastric cancer patients with bone marrow metastases. Oncology 73: Aggerholm-Pedersen N, Rasmussen P, Dybdahl H et al (2011) Serum natrium determines outcome of treatment of advanced GIST with imatinib: a retrospective study of 80 patients from a single institution. ISRN Oncol 2011: Jacot W, Colinet B, Bertrand D, Lacombe S, Bozonnat MC, Daurès JP, Pujol JL (2008) OncoLR Health Network. Quality of life and comorbidity score as prognostic determinants in non-small-cell lung cancer patients. Ann Oncol 19: Hansen O, Sørensen P, Hansen KH (2010) The occurrence of hyponatremia in SCLC and the influence on prognosis: a retrospective study of 453 patients treated in a single institution in a 10-year period. Lung Cancer 68: Petereit C, Zaba O, Teber I, Grohé C (2011) Is hyponatremia a prognostic marker of survival for lung cancer? Pneumologie 65: Schutz FA, Xie W, Donskov F et al (2014) The impact of low serum sodium on treatment outcome of targeted therapy in metastatic renal cell carcinoma: results from the International Metastatic Renal Cell Cancer Database Consortium. Eur Urol 65:

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer Pleurectomy/decortication, hyperthermic pleural lavage with povidone-iodine and systemic chemotherapy in malignant pleural mesothelioma. A 10-year experience. L Lang-Lazdunski, A Bille, S Marshall, R Lal,

More information

Research Article Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate Antimetabolite Chemotherapy

Research Article Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate Antimetabolite Chemotherapy Lung Cancer International Volume 2015, Article ID 590148, 7 pages http://dx.doi.org/10.1155/2015/590148 Research Article Malignant Pleural Mesothelioma Outcomes in the Era of Combined Platinum and Folate

More information

Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study

Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study Turkish Journal of Cancer Volume 34, No.1, 2004 19 Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study MUSTAFA ÖZDO AN, MUSTAFA SAMUR, HAKAN BOZCUK, ERKAN ÇOBAN,

More information

Malignant Pleural Mesothelioma in Singapore

Malignant Pleural Mesothelioma in Singapore RESEARCH COMMUNICATION C SP Yip 1, HN Koong 2, CM Loo 3, KW Fong 1* Abstract Aim: To examine the clinical characteristics and outcomes of malignant pleural mesothelioma (MPM) in Singapore. Methods and

More information

Activity of pemetrexed in thoracic malignancies

Activity of pemetrexed in thoracic malignancies Activity of pemetrexed in thoracic malignancies Results of phase III clinical studies of pemetrexed in malignant pleural mesothelioma and non-small cell lung cancer show benefit P emetrexed (Alimta) is

More information

Malignant Mesothelioma State of the Art

Malignant Mesothelioma State of the Art Malignant Mesothelioma State of the Art Paul Baas The Netherlands Cancer Institute August 12, 2011, Carlsbad, CA Summary Diagnosis; epithelial type subdivided Pleiomorphic vs other Staging: IASLC-IMIG

More information

NCCN Non-Small Cell Lung Cancer V.1.2011 Update Meeting 07/09/10

NCCN Non-Small Cell Lung Cancer V.1.2011 Update Meeting 07/09/10 Guideline Page and Request NSCL-3 Stage IA, margins positive delete the recommendation for chemoradiation. Stage IB, IIA, margins positive delete the recommendation for chemoradiation + Stage IIA, Stage

More information

Scottish Medicines Consortium

Scottish Medicines Consortium Scottish Medicines Consortium pemetrexed 500mg infusion (Alimta ) No. (192/05) Eli Lilly 8 July 2005 The Scottish Medicines Consortium has completed its assessment of the above product and advises NHS

More information

7. Prostate cancer in PSA relapse

7. Prostate cancer in PSA relapse 7. Prostate cancer in PSA relapse A patient with prostate cancer in PSA relapse is one who, having received a primary treatment with intent to cure, has a raised PSA (prostate-specific antigen) level defined

More information

Summary of treatment benefits

Summary of treatment benefits Risk Management Plan PEMETREXED Powder for concentrate for Solution for infusion Pemetrexed is also indicated as monotherapy for the maintenance treatment of locally advanced or metastatic non small cell

More information

Lung Cancer: More than meets the eye

Lung Cancer: More than meets the eye Lung Cancer Education Program November 23, 2013 Lung Cancer: More than meets the eye Shantanu Banerji MD, FRCPC Presenter Disclosure Faculty: Shantanu Banerji Relationships with commercial interests: Grants/Research

More information

Introduction Objective Methods Results Conclusion

Introduction Objective Methods Results Conclusion Introduction Objective Methods Results Conclusion 2 Malignant pleural mesothelioma (MPM) is the most common form of mesothelioma a rare cancer associated with long latency period (i.e. 20 to 40 years),

More information

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Maintenance therapy in in Metastatic NSCLC Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Definition of Maintenance therapy The U.S. National Cancer Institute s

More information

Malignant pleural mesothelioma P/D vs. EPP

Malignant pleural mesothelioma P/D vs. EPP 3 rd International Thoracic Oncology Congress Dresden, September 13 15, 2012 Malignant pleural mesothelioma P/D vs. EPP Walter Weder, MD Professor of Surgery Dokumentenname Datum Seite 1 Extrapleural Pneumonectomy

More information

Prior Authorization Guideline

Prior Authorization Guideline Prior Authorization Guideline Guideline: PS Inj - Alimta Therapeutic Class: Antineoplastic Agents Therapeutic Sub-Class: Antifolates Client: PS Inj Approval Date: 8/2/2004 Revision Date: 12/5/2006 I. BENEFIT

More information

Avastin: Glossary of key terms

Avastin: Glossary of key terms Avastin: Glossary of key terms Adenocarcinoma Adenoma Adjuvant therapy Angiogenesis Anti-angiogenics Antibody Antigen Avastin (bevacizumab) Benign A form of carcinoma that originates in glandular tissue.

More information

Temporal Trends in Demographics and Overall Survival of Non Small-Cell Lung Cancer Patients at Moffitt Cancer Center From 1986 to 2008

Temporal Trends in Demographics and Overall Survival of Non Small-Cell Lung Cancer Patients at Moffitt Cancer Center From 1986 to 2008 Special Report Temporal Trends in Demographics and Overall Survival of Non Small-Cell Lung Cancer Patients at Moffitt Cancer Center From 1986 to 2008 Matthew B. Schabath, PhD, Zachary J. Thompson, PhD,

More information

بسم هللا الرحمن الرحيم

بسم هللا الرحمن الرحيم بسم هللا الرحمن الرحيم Updates in Mesothelioma By Samieh Amer, MD Professor of Cardiothoracic Surgery Faculty of Medicine, Cairo University History Wagner and his colleagues (1960) 33 cases of mesothelioma

More information

SMALL CELL LUNG CANCER

SMALL CELL LUNG CANCER Protocol for Planning and Treatment The process to be followed in the management of: SMALL CELL LUNG CANCER Patient information given at each stage following agreed information pathway 1. DIAGNOSIS New

More information

Mesothelioma. 1. Introduction. 1.1 General Information and Aetiology

Mesothelioma. 1. Introduction. 1.1 General Information and Aetiology Mesothelioma 1. Introduction 1.1 General Information and Aetiology Mesotheliomas are tumours that arise from the mesothelial cells of the pleura, peritoneum, pericardium or tunica vaginalis [1]. Most are

More information

CHILDHOOD CANCER SURVIVOR STUDY Analysis Concept Proposal

CHILDHOOD CANCER SURVIVOR STUDY Analysis Concept Proposal CHILDHOOD CANCER SURVIVOR STUDY Analysis Concept Proposal 1. STUDY TITLE: Longitudinal Assessment of Chronic Health Conditions: The Aging of Childhood Cancer Survivors 2. WORKING GROUP AND INVESTIGATORS:

More information

A new score predicting the survival of patients with spinal cord compression from myeloma

A new score predicting the survival of patients with spinal cord compression from myeloma A new score predicting the survival of patients with spinal cord compression from myeloma (1) Sarah Douglas, Department of Radiation Oncology, University of Lubeck, Germany; sarah_douglas@gmx.de (2) Steven

More information

Summary ID# 13095. Clinical Study Summary: Study H3E-EW-B012

Summary ID# 13095. Clinical Study Summary: Study H3E-EW-B012 Page 1 Summary ID# 13095 Clinical Study Summary: Study H3E-EW-B012 First-line Treatment of Non-Small Cell Lung Cancer under Routine Conditions: Observational Study on Overall Survival Date summary electronically

More information

Characterisation of a Palliative Care Population in a Comprehensive Cancer Centre

Characterisation of a Palliative Care Population in a Comprehensive Cancer Centre Characterisation of a Palliative Care Population in a Comprehensive Cancer Centre Kirstine Skov Benthien, Mie Nordly, Katja Videbæk, Lisbeth Grave Bendixen, Louise Christoffersen, Hans von der Maase, Geana

More information

London Cancer. Mesothelioma Lung Protocols

London Cancer. Mesothelioma Lung Protocols London Cancer Mesothelioma Lung Protocols Version 0.9 Contents 1. Staging... 3 2. Mesothelioma Summary of Chemotherapy Protocols... 4 3. Mesothelioma Chemotherapy Protocols... 7 3.1. Pemetrexed (Alimta

More information

Characteristics of Malignant Pleural Mesothelioma in Women

Characteristics of Malignant Pleural Mesothelioma in Women Characteristics of Malignant Pleural Mesothelioma in Women Andrea S. Wolf, MD, MPH, William G. Richards, PhD, Tamara R. Tilleman, MD, PhD, Lucian Chirieac, MD, Shelley Hurwitz, PhD, Raphael Bueno, MD,

More information

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy Eur Respir J 2012; 40: 185 189 DOI: 10.1183/09031936.00153611 CopyrightßERS 2012 Population-based survival for malignant mesothelioma after introduction of novel chemotherapy Ronald A.M. Damhuis*, Caroline

More information

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT

More information

Everolimus plus exemestane for second-line endocrine treatment of oestrogen receptor positive metastatic breast cancer

Everolimus plus exemestane for second-line endocrine treatment of oestrogen receptor positive metastatic breast cancer LONDON CANCER NEWS DRUGS GROUP RAPID REVIEW Everolimus plus exemestane for second-line endocrine treatment of oestrogen receptor positive metastatic breast cancer Everolimus plus exemestane for second-line

More information

Clinical cases in Malignant Pleural Mesothelioma: Adherence to the ESMO Clinical Practice Guidelines

Clinical cases in Malignant Pleural Mesothelioma: Adherence to the ESMO Clinical Practice Guidelines Clinical cases in Malignant Pleural Mesothelioma: Adherence to the ESMO Clinical Practice Guidelines Wieneke Buikhuisen The Netherlands Cancer Institute Amsterdam The Netherlands Case (1) Male, 56 year

More information

Columbia University Mesothelioma Applied Research Foundation - 2009 - www.curemeso.org. Mesothelioma Center www.mesocenter.org

Columbia University Mesothelioma Applied Research Foundation - 2009 - www.curemeso.org. Mesothelioma Center www.mesocenter.org Columbia University Mesothelioma Center www.mesocenter.org Multimodal clinical trials, treatment (surgery, radiation, chemotherapy) Peritoneal mesothelioma program Immunotherapy translational, experimental

More information

Background. t 1/2 of 3.7 4.7 days allows once-daily dosing (1.5 mg) with consistent serum concentration 2,3 No interaction with CYP3A4 inhibitors 4

Background. t 1/2 of 3.7 4.7 days allows once-daily dosing (1.5 mg) with consistent serum concentration 2,3 No interaction with CYP3A4 inhibitors 4 Abstract No. 4501 Tivozanib versus sorafenib as initial targeted therapy for patients with advanced renal cell carcinoma: Results from a Phase III randomized, open-label, multicenter trial R. Motzer, D.

More information

REPORT ASCO 2002 ORLANDO : LUNG CANCER Johan F. Vansteenkiste, MD, PhD, Univ. Hospital and Leuven Lung Cancer Group

REPORT ASCO 2002 ORLANDO : LUNG CANCER Johan F. Vansteenkiste, MD, PhD, Univ. Hospital and Leuven Lung Cancer Group REPORT ASCO 2002 ORLANDO : LUNG CANCER Johan F. Vansteenkiste, MD, PhD, Univ. Hospital and Leuven Lung Cancer Group In the 2002 edition of the ASCO meeting, a total of 315 abstracts in the field of respiratory

More information

POLICY A. INDICATIONS

POLICY A. INDICATIONS Alimta (pemetrexed) Line(s) of Business: HMO; PPO; QUEST Integration Akamai Advantage Original Effective Date: 09/01/2007 Current Effective Date: 10/01/2015 POLICY A. INDICATIONS The indications below

More information

KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA

KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA O.E. Stakhvoskyi, E.O. Stakhovsky, Y.V. Vitruk, O.A. Voylenko, P.S. Vukalovich, V.A. Kotov, O.M. Gavriluk National Canсer Institute,

More information

Lung cancer is not just one disease. There are two main types of lung cancer:

Lung cancer is not just one disease. There are two main types of lung cancer: 1. What is lung cancer? 2. How common is lung cancer? 3. What are the risk factors for lung cancer? 4. What are the signs and symptoms of lung cancer? 5. How is lung cancer diagnosed? 6. What are the available

More information

Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof.

Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof. Corso Integrato di Clinica Medica ONCOLOGIA MEDICA AA 2010-2011 LUNG CANCER. VIII. THERAPY. V. SMALL CELL LUNG CANCER Prof. Alberto Riccardi SMALL CELL LUNG CARCINOMA Summary of treatment approach * limited

More information

Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma. Claire Vines, 2016 Pharm.D. Candidate

Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma. Claire Vines, 2016 Pharm.D. Candidate + Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma Claire Vines, 2016 Pharm.D. Candidate + Disclosure I have no conflicts of interest to disclose. + Objectives Summarize NCCN

More information

Mesothelioma. Malignant Pleural Mesothelioma

Mesothelioma. Malignant Pleural Mesothelioma Mesothelioma William G. Richards, PhD Brigham and Women s Hospital Malignant Pleural Mesothelioma 2,000-3,000 cases per year (USA) Increasing incidence Asbestos (50-80%, decreasing) 30-40 year latency

More information

If several different trials are mentioned in one publication, the data of each should be extracted in a separate data extraction form.

If several different trials are mentioned in one publication, the data of each should be extracted in a separate data extraction form. General Remarks This template of a data extraction form is intended to help you to start developing your own data extraction form, it certainly has to be adapted to your specific question. Delete unnecessary

More information

Pharmacogenomic markers in EGFR-targeted therapy of lung cancer

Pharmacogenomic markers in EGFR-targeted therapy of lung cancer Pharmacogenomic markers in EGFR-targeted therapy of lung cancer Rafal Dziadziuszko, MD, PhD University of Colorado Cancer Center, Aurora, CO, USA Medical University of Gdansk, Poland EMEA Workshop on Biomarkers,

More information

Treatment of Metastatic Non-Small Cell Lung Cancer: A Systematic Review of Comparative Effectiveness and Cost-Effectiveness

Treatment of Metastatic Non-Small Cell Lung Cancer: A Systematic Review of Comparative Effectiveness and Cost-Effectiveness Department of Veterans Affairs Health Services Research & Development Service Treatment of Metastatic Non-Small Cell Lung Cancer: A Systematic Review of Comparative Effectiveness and Cost-Effectiveness

More information

A new score predicting the survival of patients with spinal cord compression from myeloma

A new score predicting the survival of patients with spinal cord compression from myeloma A new score predicting the survival of patients with spinal cord compression from myeloma (1) Sarah Douglas, Department of Radiation Oncology, University of Lubeck, Germany; sarah_douglas@gmx.de (2) Steven

More information

National Horizon Scanning Centre. Vandetanib (Zactima) for advanced or metastatic non-small cell lung cancer. December 2007

National Horizon Scanning Centre. Vandetanib (Zactima) for advanced or metastatic non-small cell lung cancer. December 2007 Vandetanib (Zactima) for advanced or metastatic non-small cell lung cancer December 2007 This technology summary is based on information available at the time of research and a limited literature search.

More information

Treatment Algorithms for the Management of Lung Cancer in NSW Guide for Clinicians

Treatment Algorithms for the Management of Lung Cancer in NSW Guide for Clinicians Treatment Algorithms for the Management of Lung Cancer in NSW Guide for Clinicians Background The Cancer Institute New South Wales Oncology Group Lung (NSWOG Lung) identified the need for the development

More information

Malignant Mesothelioma: an Update

Malignant Mesothelioma: an Update Malignant Mesothelioma: an Update Nico van Zandwijk Asbestos Diseases Research Institute Bernie Banton Centre University of Sydney Australia Physicians Week RACP 19-5-2009 Health Risks of Asbestos Fibers

More information

REPORT PERSPECTIVES IN LUNG CANCER 2010 AMSTERDAM

REPORT PERSPECTIVES IN LUNG CANCER 2010 AMSTERDAM REPORT PERSPECTIVES IN LUNG CANCER 2010 AMSTERDAM Valerie Van Damme, Isabelle Wauters, Johan Vansteenkiste Univ. Hospital Leuven and Leuven Lung Cancer Group Introduction Perspectives in Lung Cancer (PILC)

More information

Adiuwantowe i neoadiuwantowe leczenie chorych na zaawansowanego raka żołądka

Adiuwantowe i neoadiuwantowe leczenie chorych na zaawansowanego raka żołądka Adiuwantowe i neoadiuwantowe leczenie chorych na zaawansowanego raka żołądka Neoadiuvant and adiuvant therapy for advanced gastric cancer Franco Roviello, IT Neoadjuvant and adjuvant therapy for advanced

More information

Malignant Mesothelioma

Malignant Mesothelioma Malignant Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)

More information

Malignant Mesothelioma

Malignant Mesothelioma Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)

More information

Prostatectomy, pelvic lymphadenect. Med age 63 years Mean followup 53 months No other cancer related therapy before recurrence. Negative.

Prostatectomy, pelvic lymphadenect. Med age 63 years Mean followup 53 months No other cancer related therapy before recurrence. Negative. Adjuvante und Salvage Radiotherapie Ludwig Plasswilm Klinik für Radio-Onkologie, KSSG CANCER CONTROL WITH RADICAL PROSTATECTOMY ALONE IN 1,000 CONSECUTIVE PATIENTS 1983 1998 Clinical stage T1 and T2 Mean

More information

Malignant Pleural Diseases Advances Clinicians Should Know F Gleeson

Malignant Pleural Diseases Advances Clinicians Should Know F Gleeson Malignant Pleural Diseases Advances Clinicians Should Know F Gleeson The following relevant disclosures, conflicts of interest and/ or financial relationships exist related to this presentation: Consultant

More information

Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro. Joon H. Lee 9/17/2012

Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro. Joon H. Lee 9/17/2012 Extrapleural Pneumonectomy for Malignant Mesothelioma: Pro Joon H. Lee 9/17/2012 Malignant Pleural Mesothelioma (Epidemiology) Incidence: 7/mil (Japan) to 40/mil (Australia) Attributed secondary to asbestos

More information

ASBESTOS EXPOSURE AND SARCOMATOID MALIGNANT PLEURAL MESOTHELIOMA Gorantla Sambasivarao 1, Namballa Usharani 2, Tupakula Suresh Babu 3

ASBESTOS EXPOSURE AND SARCOMATOID MALIGNANT PLEURAL MESOTHELIOMA Gorantla Sambasivarao 1, Namballa Usharani 2, Tupakula Suresh Babu 3 ASBESTOS EXPOSURE AND SARCOMATOID MALIGNANT PLEURAL MESOTHELIOMA Gorantla Sambasivarao 1, Namballa Usharani 2, Tupakula Suresh Babu 3 HOW TO CITE THIS ARTICLE: Gorantla Sambasivarao, Namballa Usharani,

More information

PET/CT in Lung Cancer

PET/CT in Lung Cancer PET/CT in Lung Cancer Rodolfo Núñez Miller, M.D. Nuclear Medicine and Diagnostic Imaging Section Division of Human Health International Atomic Energy Agency Vienna, Austria GLOBOCAN 2012 #1 #3 FDG-PET/CT

More information

Komorbide brystkræftpatienter kan de tåle behandling? Et registerstudie baseret på Danish Breast Cancer Cooperative Group

Komorbide brystkræftpatienter kan de tåle behandling? Et registerstudie baseret på Danish Breast Cancer Cooperative Group Komorbide brystkræftpatienter kan de tåle behandling? Et registerstudie baseret på Danish Breast Cancer Cooperative Group Lotte Holm Land MD, ph.d. Onkologisk Afd. R. OUH Kræft og komorbiditet - alle skal

More information

Clinical Aspects of Hyponatremia & Hypernatremia

Clinical Aspects of Hyponatremia & Hypernatremia Clinical Aspects of Hyponatremia & Hypernatremia Case Presentation: History 62 y/o male is admitted to the hospital with a 3 month history of excessive urination (polyuria) and excess water intake up to

More information

Development of Bone Metastases in Men With Prostate Cancer

Development of Bone Metastases in Men With Prostate Cancer Development of Bone Metastases in Men With Prostate Cancer Explore the Causes Understand the Consequences Natural History of Prostate Cancer Progression Many prostate tumors may become castrate-resistant

More information

Non-small cell lung cancer, advanced or metastatic, switch-therapy after gemcitabine/carboplatin

Non-small cell lung cancer, advanced or metastatic, switch-therapy after gemcitabine/carboplatin COMPENDIA TRANSPARENCY TRACKING FORM DRUG: Docetaxel INDICATION: Non-small cell lung cancer, advanced or metastatic, switch-therapy after gemcitabine/carboplatin COMPENDIA TRANSPARENCY REQUIREMENTS 1 Provide

More information

CABOZANTINIB VERSUS EVEROLIMUS IN PATIENTS WITH ADVANCED RENAL CELL CARCINOMA: RESULTS OF A RANDOMISED PHASE III TRIAL (METEOR)

CABOZANTINIB VERSUS EVEROLIMUS IN PATIENTS WITH ADVANCED RENAL CELL CARCINOMA: RESULTS OF A RANDOMISED PHASE III TRIAL (METEOR) CABOZANTINIB VERSUS EVEROLIMUS IN PATIENTS WITH ADVANCED RENAL CELL CARCINOMA: RESULTS OF A RANDOMISED PHASE III TRIAL (METEOR) This late-breaking abstract was presented on 26 th September 215 in Presidential

More information

NEOPLASMS OF KIDNEY (RENAL CELL CARCINOMA) And RENAL PELVIS (TRANSITIONAL CELL CARCINOMA)

NEOPLASMS OF KIDNEY (RENAL CELL CARCINOMA) And RENAL PELVIS (TRANSITIONAL CELL CARCINOMA) NEOPLASMS OF KIDNEY (RENAL CELL CARCINOMA) And RENAL PELVIS (TRANSITIONAL CELL CARCINOMA) Merat Esfahani, MD Medical Oncologist, Hematologist Cancer Liaison Physician SwedishAmerican Regional Cancer Center

More information

Emerging Drug List GEFITINIB

Emerging Drug List GEFITINIB Generic (Trade Name): Manufacturer: Gefitinib (Iressa ) formerly referred to as ZD1839 AstraZeneca NO. 52 JANUARY 2004 Indication: Current Regulatory Status: Description: Current Treatment: Cost: Evidence:

More information

Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment.

Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment. 1 Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment. John T. Carpenter, M.D. University of Alabama at Birmingham NP 2508 1720 Second Avenue South Birmingham, AL 35294-3300

More information

J Clin Oncol 24:3007-3012. 2006 by American Society of Clinical Oncology INTRODUCTION

J Clin Oncol 24:3007-3012. 2006 by American Society of Clinical Oncology INTRODUCTION VOLUME 24 NUMBER 19 JULY 1 2006 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Progression-Free Survival Rate As Primary End Point for Phase II Cancer Clinical Trials: Application to Mesothelioma

More information

Dr Peter Briggs Medical Oncologist. Lung Cancer & Mesothelioma: is it worth treating?

Dr Peter Briggs Medical Oncologist. Lung Cancer & Mesothelioma: is it worth treating? Dr Peter Briggs Medical Oncologist Lung Cancer & Mesothelioma: is it worth treating? GOALS OF CANCER THERAPY CURE Good chance Medium chance Low chance PALLIATION Life prolonging Symptomatic improvement

More information

Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma

Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma I d like to welcome everyone, thanks for coming out to our lunch with experts. The faculty today are great people in the thoracic

More information

Male. Female. Death rates from lung cancer in USA

Male. Female. Death rates from lung cancer in USA Male Female Death rates from lung cancer in USA Smoking represents an interesting combination of an entrenched industry and a clearly drug-induced cancer Tobacco Use in the US, 1900-2000 5000 100 Per Capita

More information

Post-operative intrapleural chemotherapy for mesothelioma

Post-operative intrapleural chemotherapy for mesothelioma Post-operative intrapleural chemotherapy for mesothelioma Robert Kratzke, MD John Skoglund Chair for Lung Cancer Research Section of Heme-Onc-Transplant University of Minnesota Medical School Efficacy

More information

Management of mesothelioma

Management of mesothelioma Management of mesothelioma Jan.vanmeerbeeck@ugent.be Amsterdam, March 6, 2010 1 management Palliation Symptomatic care Pain Breathlessness Radiotherapy Chemotherapy Surgery Radical (intention to cure)

More information

Social inequalities impacts of care management and survival in patients with non-hodgkin lymphomas (ISO-LYMPH)

Social inequalities impacts of care management and survival in patients with non-hodgkin lymphomas (ISO-LYMPH) Session 3 : Epidemiology and public health Social inequalities impacts of care management and survival in patients with non-hodgkin lymphomas (ISO-LYMPH) Le Guyader-Peyrou Sandra Bergonie Institut Context:

More information

Avastin in Metastatic Breast Cancer

Avastin in Metastatic Breast Cancer Non-interventional study Avastin in Metastatic Breast Cancer ML 21165 / 2007 Clinical Study Report Synopsis ROCHE ML21165 / WiSP Project RH09 / V. 1.0 / 24.06.2013 ROCHE ML21165-2 - Name of Sponsor Roche

More information

Ching-Yao Yang, Yu-Wen Tien

Ching-Yao Yang, Yu-Wen Tien Ching-Yao Yang, Yu-Wen Tien Division of General Surgery, Department of Surgery, National Taiwan University Hospital Oct-30-2010 Pancreatic NET have poorer prognosis when presence of liver metastases at

More information

Is there a positive effect of participation on a clinical trial for patients with advanced nonsmall cell lung cancer?

Is there a positive effect of participation on a clinical trial for patients with advanced nonsmall cell lung cancer? Original Article Is there a positive effect of participation on a clinical trial for patients with advanced nonsmall cell lung cancer? Rajappa S, Gundeti S, Uppalapati S, Jiwatani S, Abhyankar A, Pal C,

More information

Role of taxanes in the treatment of advanced NHL patients: A randomized study of 87 cases

Role of taxanes in the treatment of advanced NHL patients: A randomized study of 87 cases Role of taxanes in the treatment of advanced NHL patients: A randomized study of 87 cases R. Shraddha, P.N. Pandit Radium Institute, Patna Medical College and Hospital, Patna, India Abstract NHL is a highly

More information

Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: An institutional experience in Turkey

Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: An institutional experience in Turkey JBUON 2014; 19(1): 164-170 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mail: editorial_office@jbuon.com ORIGINAL ARTICLE Clinical characteristics, treatment and survival outcomes in malignant

More information

Avastin in breast cancer: Summary of clinical data

Avastin in breast cancer: Summary of clinical data Avastin in breast cancer: Summary of clinical data Worldwide, over one million people are diagnosed with breast cancer every year 1. It is the most frequently diagnosed cancer in women 1,2, and the leading

More information

New strategies in anticancer therapy

New strategies in anticancer therapy 癌 症 診 療 指 引 簡 介 及 臨 床 應 用 New strategies in anticancer therapy 中 山 醫 學 大 學 附 設 醫 院 腫 瘤 內 科 蔡 明 宏 醫 師 2014/3/29 Anti-Cancer Therapy Surgical Treatment Radiotherapy Chemotherapy Target Therapy Supportive

More information

Surgeons Role in Symptom Management. A/Prof Cliff K. C. Choong Consultant Thoracic Surgeon Latrobe Regional Hospital GIPPSLAND

Surgeons Role in Symptom Management. A/Prof Cliff K. C. Choong Consultant Thoracic Surgeon Latrobe Regional Hospital GIPPSLAND Surgeons Role in Symptom Management A/Prof Cliff K. C. Choong Consultant Thoracic Surgeon Latrobe Regional Hospital GIPPSLAND Conditions PLEURAL Pleural effusion Pneumothorax ENDOBRONCHIAL Haemoptysis

More information

BNC105 CANCER CLINICAL TRIALS REACH KEY MILESTONES CLINICAL PROGRAM TO BE EXPANDED

BNC105 CANCER CLINICAL TRIALS REACH KEY MILESTONES CLINICAL PROGRAM TO BE EXPANDED ASX ANNOUNCEMENT 3 August 2011 ABN 53 075 582 740 BNC105 CANCER CLINICAL TRIALS REACH KEY MILESTONES CLINICAL PROGRAM TO BE EXPANDED Data from renal cancer trial supports progression of the trial: o Combination

More information

Medication Policy Manual. Topic: Alimta, pemetrexed Date of Origin: May 12, 2010

Medication Policy Manual. Topic: Alimta, pemetrexed Date of Origin: May 12, 2010 Medication Policy Manual Policy No: dru213 Topic: Alimta, pemetrexed Date of Origin: May 12, 2010 Committee Approval Date: February 17, 2015 Next Review Date: February 2016 Effective Date: March 1, 2015

More information

Rare Thoracic Tumours

Rare Thoracic Tumours Rare Thoracic Tumours 1. Epithelial Tumour of Trachea 1 1.1 General Results Table 1. Epithelial Tumours of Trachea: Incidence, Trends, Survival Flemish Region 2001-2010 Both Sexes Incidence Trend EAPC

More information

Multidisciplinary discussion of: Early staged NSCLC

Multidisciplinary discussion of: Early staged NSCLC Multidisciplinary discussion of: Early staged NSCLC 2 different classes of patients Stage IIIA pt2pn2 Stage IIB pt3pn0 2 different classes of patients 50% 40% 30% 20% 10% 3y survival 50% 40% 30% 20% 10%

More information

prognostic scoring systems. We

prognostic scoring systems. We Thorax 2000;55:731 735 731 Original articles Prognostic factors for malignant mesothelioma in 142 patients: validation of CALGB and EORTC prognostic scoring systems J G Edwards, K R Abrams, J N Leverment,

More information

Kanıt: Klinik çalışmalarda ZYTIGA

Kanıt: Klinik çalışmalarda ZYTIGA mkdpk de Sonunda Gerçek İlerleme! Kanıt: Klinik çalışmalarda ZYTIGA Dr. Sevil Bavbek 5. Türk Tıbbi Onkoloji Kongresi Mart 214, Antalya Endocrine therapies Adrenals Testis Abiraterone Orteronel Androgen

More information

Clinical Indications and Results Following Chest Wall Resection

Clinical Indications and Results Following Chest Wall Resection Clinical Indications and Results Following Chest Wall Resection for Recurrent Malignant Pleural Mesothelioma Ali SO, Burt BM, Groth SS, DaSilva MC, Yeap BY, Richards WG, Baldini EH and Sugarbaker DJ. Division

More information

Small Cell Lung Cancer

Small Cell Lung Cancer Small Cell Lung Cancer Lung Practice Guideline Dr. Brian Dingle MSc, MD, FRCPC Approval Date: April 2007 Revised: November 2008 This guideline is a statement of consensus of the Thoracic Disease Site Team

More information

Update on Small Cell Lung Cancer

Update on Small Cell Lung Cancer Welcome to Master Class for Oncologists Session 3: 2:45 PM - 3:30 PM Washington, DC March 28, 2009 Small Cell Lung Cancer: Best Practices & Recent Advances Speaker: Bruce E. Johnson, MD Professor of Medicine,

More information

Understanding Clinical Trials

Understanding Clinical Trials Understanding Clinical Trials HR =.6 (CI :.51.7) p

More information

Primary -Benign - Malignant Secondary

Primary -Benign - Malignant Secondary TUMOURS OF THE LUNG Primary -Benign - Malignant Secondary The incidence of lung cancer has been increasing almost logarithmically and is now reaching epidemic levels. The overall cure rate is very low

More information

Report on New Patented Drugs - Alimta

Report on New Patented Drugs - Alimta Report on New Patented Drugs - Alimta Under its transparency initiative, the PMPRB publishes the results of the reviews of new patented drugs by Board Staff, for purposes of applying the PMPRB s Excessive

More information

Brigham and Women s Hospital, Boston, MA, USA; 2 Verastem, Inc., Boston, MA, USA

Brigham and Women s Hospital, Boston, MA, USA; 2 Verastem, Inc., Boston, MA, USA Determination of Biomarker Response in a Phase II Window of Opportunity Study of Defactinib (VS 6063), a Focal Adhesion Kinase (FAK) Inhibitor, in Patients with Resectable Malignant Pleural Mesothelioma

More information

Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.

Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509. Efficacy Results from the ToGA Trial: A Phase III Study of Trastuzumab Added to Standard Chemotherapy in First-Line HER2- Positive Advanced Gastric Cancer Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.

More information

Evaluation of Treatment Pathways in Oncology: An Example in mcrpc

Evaluation of Treatment Pathways in Oncology: An Example in mcrpc Evaluation of Treatment Pathways in Oncology: An Example in mcrpc Sonja Sorensen, MPH United BioSource Corporation Bethesda, MD 1 Objectives Illustrate selection of modeling approach for evaluating pathways

More information

West of Scotland Cancer Network Chemotherapy Protocol. Cisplatin and Pemetrexed for Malignant Mesothelioma (LUWOS 0021)

West of Scotland Cancer Network Chemotherapy Protocol. Cisplatin and Pemetrexed for Malignant Mesothelioma (LUWOS 0021) West of Scotland Cancer Network Chemotherapy Protocol Cisplatin and Pemetrexed for Malignant Mesothelioma (LUWOS 0021) Indication Palliative chemotherapy for malignant mesothelioma of the pleura Eligibility

More information

What is the reference cytotoxic regimen in advanced gastric cancer?

What is the reference cytotoxic regimen in advanced gastric cancer? What is the reference cytotoxic regimen in advanced gastric cancer? Florian Lordick Professor of Oncology Director of the University Cancer Center Leipzig (UCCL) Germany What we know from clinical research.

More information

Third-line or fourth-line chemotherapy in non-small-cell lung cancer patients with relatively good performance status

Third-line or fourth-line chemotherapy in non-small-cell lung cancer patients with relatively good performance status Available online at www.sciencedirect.com Journal of the Chinese Medical Association 74 (2011) 209e214 Original Article Third-line or fourth-line chemotherapy in non-small-cell lung cancer patients with

More information

MesoPDT. Photodynamic Therapy for malignant pleural mesothelioma ONCO-THAI. Image Assisted Laser Therapy for Oncology

MesoPDT. Photodynamic Therapy for malignant pleural mesothelioma ONCO-THAI. Image Assisted Laser Therapy for Oncology MesoPDT Photodynamic Therapy for malignant pleural mesothelioma ONCO-THAI Image Assisted Laser Therapy for Oncology Unité Inserm ONCO-THAI «Image Assisted Laser Therapy for Oncology» Inserm ONCO-THAI "Image

More information

Management of stage III A-B of NSCLC. Hamed ALHusaini Medical Oncologist

Management of stage III A-B of NSCLC. Hamed ALHusaini Medical Oncologist Management of stage III A-B of NSCLC Hamed ALHusaini Medical Oncologist Global incidence, CA cancer J Clin 2011;61:69-90 Stage III NSCLC Includes heterogeneous group of patients with differences in the

More information

The value of inflammatory parameters in the prognosis of malignant mesothelioma

The value of inflammatory parameters in the prognosis of malignant mesothelioma Clinical Report The value of inflammatory parameters in the prognosis of malignant mesothelioma Journal of International Medical Research 2014, Vol. 42(2) 554 565! The Author(s) 2014 Reprints and permissions:

More information