Primárne lymfómy CNS (PCNSL) M.Petrilák, VOÚ a.s.
|
|
|
- Sheila Baker
- 9 years ago
- Views:
Transcription
1 Primárne lymfómy CNS (PCNSL) M.Petrilák, VOÚ a.s.
2 Definícia-PCNSL extranodálny NHL kraniospinálnej osi ( mozog, leptomeningy, miecha, oči) bez postihnutia mimo CNS zriedkavé formy- indolentné NHL - mozgová lymfomatóza - neurolymfomatóza - primárny intraokulárny lymfóm - lymfómy dura mater
3 incid. - 0,5 / / rok Epidemiológia 1-2% extranodal. NHL 4% novodiagnostikovaných mozgových nádorov nárast incidencie posledných 30 rokov medián veku: 61 rokov / 30 rokov AIDS 2% pacientov s AIDS- AIDS asociovaná choroba
4 95% DLBCL Patológia a varianty PCNSL Burkittov lymfóm Lymfóm marginálnej zóny SLL/CLL T- bunkové lymfómy
5 Klinické príznaky Bataille B, et al: Primary intracerebral malignant lymphoma: A report of 248 cases. J Neurosurg 92: , 2000
6 Diagnostika PCNSL International PCNSL Collaborative group Guidelines Patológia Klinika Laboratórne Zobrazovacie Biopsia, histológia, hodnotenie patológa Kompletné fyzikálne + neurolog. vyšetrenie Očné vyšetrenie + vyšetrenie štrbinovou lampou HIV serológia CSF cytológia, flow cytometria IgH PCR Kontrastné MRI mozgu CT hrudník, abdomen, pelvis Imunofenotyp Prognostické faktory (vek,ps...) Hodnotenie kognitívnych funkcií 24 hodinový zber moču - klírens kretainínu Trepanobiopsia kostnej drene USG semenníkov PET? - systémové ochorenie7%, falošná pozitivita 13% 20-40% leptomeningeálna infiltr., 5% očná infiltr. Abrey LE, et al: Report of an international workshop to standardize baseline evaluation and response criteria for primary central nervous system lymphoma. J Clin Oncol 23: , 2005
7 Prognostické faktory Ann Arbor staging- IE, bez progn. významu International Extranodal Lymphoma Study Group IELSG- parameters associated with poor prognosis: vek> 60 r. ECOG > 1 LDH elevácia hladina bielkovin v likvore postihnutie hlbokých častí mozgu (periventrikulárne oblasti, bazálne ganglia, mozgový kmeň, mozoček)
8 Prognostické skupiny vek> 60 r. ECOG > 1 LDH elevácia hladina bielkovin v likvore postih. hlbokých častí mozgu Skóre 2-ročný OS % % % Ferreri AJ et al: Prognostic scoring system for primary CNS lymphomas: The International Extranodal Lymphoma Study Group experience. J Clin Oncol 21: , 2003
9 2011 by American Society of Hematology Management of PCNSL
10 PCNSL- liečebné aspekty extrémne rádiosenzitívny a chemosenzitívny nádor častý relaps ochorenia súčasné štúdie - snaha identifikovať najvhodnejšiu kombinovanú liečbu minimalizácia liečbou indukovanej neurotoxicity - významná pozornosť v liečbe PCNSL
11 Terapeutické stratégie Reni M, et al. Ann Oncol 1997
12 Chirurgia v liečbe PCNSL odstránenie veľkej TU masy, debulking bez benefitu prežívania oproti biopsii prežívanie po chirurgickej liečbe sólo 1-4 mesiace multifokálne postihnutie, lokalizácia v hĺbke nemožnosť kompletnej chirurgickej resekcie úloha chirurgie diagnostická, stereotaktická biopsia indikovaná pre všetkých pacientov so symptomatológiou PCNSL
13 Kortikosteroidy v liečbe PCNSL lymfotoxický efekt cez cytoplazmatické steroidné receptory podanie dexametazonu - inciálna CR (15%) PR (25%) remisia dočasná vysadenie progresia odporúčane vysadenie liečby 7-10 dní pred biopsiou falošná negativita podávanie po biopsii, indikácia ICH
14 Rádioterapia sólo v liečbe PCNSL difúzna infiltrácia- indikácia WBRT Boost, >50Gy = riziko neurotoxicity bez účinnosti, lokálne relapsy, riziko >60 rokov 5r OS = 4% Dávka Gy ORR 90% Median OS Relaps v ožarovanom poli 11,6 mesiaca 61% Nelsion DF et al:nhl of the brain: Can high dose,large volume radiation therapy improve survival? Report on a prospective trial by the RTOG;RTOG8315.Int J Radiat.Oncol Biol Phys 23;9-17,1992
15 Indikácie rádioterapie sólo exkluzívna liečba pri kontraindikácii CHT kortikosteroid maintenance po WBRT kuratívna metóda - indolentné lymfómy (marginalnej zóny, SLL/CLL) príčiny zlýhania - asymptomatická okulárna a CSF infiltrácia - potenciálny rezervoár ochorenia pri sólo WBRT
16 Chemoterapia v liečbe PCNSL Štandardná liečba systémových NHL - prechodné odpovede mozgových lézii časté relapsy leptomeningeálna infiltrácia pri relapse štyri prospektívne štúdie nepotvrdená superiorita pridania CHOP/CHOD +WBRT versus WBRT sólo CHOP - žiadna úloha v liečbe PCNSL
17 Chemoterapia- metotrexát pacienti so systémovým NHL s relapsom v CNS reagovali na vysoké dávky MTX schopnosť vysokodávkovaného MTX preniknúť do CNS atraktívny pre liečbu PCNSL rýchla infúzia vysokej dávky MTX významne zvyšuje hladinu lieku v mozgovomiechovom moku (maximálna terapeutická koncentrácia 4-6 hodina) a zostáva nad minimálnou terapeutickou koncentráciou v CSF po dobu až 24 hodín ( krv / CSF pomer 30:1 ) MTX režimy - významná superiorita versus RT sólo
18 HD-MTX režimy dávka max 8g/m² > 1g/m² parenchým > 3g/m² CSF 8g/m² monoterapia = 3g/m² polychemoterapia 3,5g/m²- odporúčana dávka v kombinácii Režim trvanie infúzie 3 hodiny opakovanie cyklu 2 týždne - 3 týždne dávka > 3g/m²
19 Chemoterapeutické režimy Ferreri AJM, et al. The Lancet 2009
20 IELSG 20 79pp., histologicky NHL, CNS, merateľná lézia, r., ECOG < 3 MTX 3,5g/m², d1 ( x4 c; á 3 td ) + WBRT MTX 3,5g/m², d1 arac 2g/m² x 2/d, d 2-3 ( x4 c; á 3 td ) +WBRT
21 IELSG 20 : účinnosť, toxicita Ferreri AJM, et al. The Lancet 2009
22 IELSG 20- median f-up : 30 mesiacov Ferreri AJM, et al. The Lancet 2009
23 IELSG 20- median f-up : 46 mesiacov
24 MTX + arac Ferreri AJM, et al., The Oncologist 2011
25 Liečba PCNSL HD-MTX / ara - C kombinácia = súčasný štandard chemoterapie de novo PCNSL v dávke MTX 3,5g/m² D1 + ara-c 2g/m² x 2/d D2-3 q21d
26 Nové lieky
27 Rituximab Rituximab (anti-cd20 monoklonová protilátka) zmenil históriu liečby DLBCL, najčastejšej formy PCNSL. Existuje veľa pochybností o jeho schopnosti prieniku HEB. Harjunpaa, et al., L&L 2001; Ruhstaller et al., Ann Oncol 2000; Raizer, et al., ASCO 2000 Diskutovaná úloha rituximabu v znížení rizika CNS relapsu u DLBCL (R-CHOP French vs. RICOVER-60 trials). Feugier P, et al., Ann Oncol 2004; Boehme V, et al. Blood 2009 Liečba CNS lymfómov s R sólo konfliktné výsledky. Raizer JJ, et al., ASCO 2000; Ruhstaller TW, et al., Ann Oncol 2000; Pels H, et al., J Neuro-Oncol 2002 Účinnosť s HD-MTX, mierne zvýšené ORR (R-MPV). Shah GD, et al. JCO 2007
28 Temozolomid Salvage TMZ ORR= 31%, median 7 mesiacov. (36 pacientov s r/r PCNSL). Účinný v kombinácii s rituximabom. Reni M, et al. BJC 2007 Enting RH, et al. Neurology 2004;Wong ET, et al. Cancer 2004 Sinergický efekt s PARP inhibítormi na myšacích modeloch. Tentori L, et al. Blood 2002 TMZ + HD-MTX komb. účinná ORR: 45% (23 pp. vyšší vek ) Omuro A, et al. JNO 2007 Prvolíniový TMZ CR 47% (17 pacientov (62-90 rokov). Kurzwelly D, et al. JNO 2010
29 Intratekálna chemoterapia CSF rezervoár tumorových buniek použitie IT CHT pri použití HD-MTX sporné 2 veľké retrospektívne štúdie nepotvrdili benefit pridania IT CHT výsledky 2 nezávislých ramien 2 štúdii s/bez IT CHT, RR porovn., PFS 21 vs. 12 mesiacov indikácia intratekálnej CHT- leptomeningeal. infiltr.
30 HD-CHT/ASCT relaps/refraktérne ochorenie 60% CR 2 ročný OS 45% mortalita 16% prvolíniová liečba - mladí pacienti, - rezistentné ochorenie 2 štúdie - NCT , NCT pp. CHT SD,PR WBRT vs. HD-CHT/ASCT
31 Konsolidačná rádioterapia reziduálne ochorenie po primárnej CHT sporné odporúčanie pri dosiahnutí CR CALGB 50202, 44pp., fáza 2 - HD-MTX +TMZ+R konsolidácia HD ara - C + HD VP16, 4 ročný PFS 50%, OS 67% G - PCNSL-SG1, 551pp. fáza 3 HD - MTX CR WBRT vs. observácia, PFS 18 vs.12 mesiacov, OS nepotvrdené redukcia dávky Gy rovnaké výsledky Ferreri AJ, et al.,consolidation radiotherapy in PCNSL. Int Jradiat Oncol Biol Phys 2011;80(1);
32 G-PCNSL-SG-1, random. fáza III, 551pp noninferioritná štúdia
33 Relaps vek, PS, lokalizácia, 1-líniová liečba, trvanie odpovede WBRT po CHT sólo reindukcia HD-MTX ( odpoveď > 12 mesiacov ) kombinované salvage režimy, HD-CHT/ASCT klinické štúdie extra CNS diseminácia 3-7%- konvenčná CHT
34 Nové klinické štúdie
35 Take Home Messages Štúdie IELSG #20 and G-PCNSL-SG -1 nová éra randomizovaných štúdií v liečbe PCNSL. Potrebné štúdie hodnotiace jednotlivé lieky pri r/r PCNSL Režim MTX + arac podporený vysokou úrovňou dôkazov odporúčaný ako kontrolné rameno v randomizovaných šúdiach. Konsolidačnú WBRT nutné optimalizovať. HDCHT/ASCT experimentálna strategia, ktorá si zaslúži byť hodnotená v randomizovaných štúdiach. Lepšie poznanie farmakogenetiky a markerov predikujúcich toxicitu = zlepšenie tolerability a účinnosti liečby
Audience Response Question?
Presenter Disclosure Information Session 4: 3:30 PM - 4:15 PM Non-Hodgkin s Lymphomas: Optimizing Therapeutic Choices for Initial Management Speaker: Arnold S. Freedman, MD The following relationships
Lenalidomide (LEN) in Patients with Transformed Lymphoma: Results From a Large International Phase II Study (NHL-003)
Lenalidomide (LEN) in Patients with Transformed Lymphoma: Results From a Large International Phase II Study (NHL-003) Reeder CB et al. Proc ASCO 2010;Abstract 8037. Introduction > Patients (pts) with low-grade
New Targets and Treatments for Follicular Lymphoma. Disclosures
Winship Cancer Institute of Emory University New Targets and Treatments for Follicular Lymphoma Jonathon B. Cohen, MD, MS Assistant Professor Div of BMT, Emory University Disclosures Consulting fees from:
Audience Response Question? Non-Hodgkin s Lymphomas: Optimizing Therapeutic Choices for Initial Management. Presenter Disclosure Information
Welcome to Master Class for Oncologists Session 4: 10:00 AM - 10:45 AM Miami, FL December 18, 2009 Non-Hodgkin s Lymphomas: Optimizing Therapeutic Choices for Initial Management Speaker: Arnold S. Freedman,
Management of low grade glioma s: update on recent trials
Management of low grade glioma s: update on recent trials M.J. van den Bent The Brain Tumor Center at Erasmus MC Cancer Center Rotterdam, the Netherlands Low grades Female, born 1976 1 st seizure 2005,
Aggressive lymphomas. Michael Crump Princess Margaret Hospital
Aggressive lymphomas Michael Crump Princess Margaret Hospital What are the aggressive lymphomas? Diffuse large B cell Mediastinal large B cell Anaplastic large cell Burkitt lymphoma (transformed lymphoma:
PRIMARY GLIOMA (oligodendroglioma, astrocytoma, oligodendroglioma, oligoastrocytoma, including anaplastic, gliosarcoma and glioblastoma multiforme)
Protocol for Planning and Treatment The process to be followed when a course of chemotherapy is required to treat: PRIMARY GLIOMA (oligodendroglioma, astrocytoma, oligodendroglioma, oligoastrocytoma, including
Frequency of NHL Subtypes in Adults
Chemotherapy Options Stephanie A. Gregory, M.D. The Elodia Kehm Professor of Medicine Director, Section of Hematology Rush University Medical Center Chicago, Illinois Frequency of NHL Subtypes in Adults
Radioterapia panencefalica. Umberto Ricardi
Radioterapia panencefalica Umberto Ricardi Background Systemic disease to the brain is unfortunately a quite common event Radiotherapy, especially with the great technical development during the past decades,
IF AT FIRST YOU DON T SUCCEED: TRIAL, TRIAL AGAIN
+ IF AT FIRST YOU DON T SUCCEED: TRIAL, TRIAL AGAIN Rena Buckstein MD FRCPC Head Hematology Site Group Sunnybrook Odette Cancer Center (OCC) Head of Hematology Clinical Trials Group at OCC + Outline Start
Rituximab in Non - Hodgkins Lymphoma. Fatima Bassa, Dept. of Haematology October 2008
Rituximab in Non - Hodgkins Lymphoma Fatima Bassa, Dept. of Haematology October 2008 World Health Organization lymphoma classification (2001) Peripheral B-cell neoplasms: B-chronic lymphocytic leukemia/small
6/3/2013. Follicular and Other Slow Growing Lymphomas. Stephen Ansell, MD, PhD Mayo Clinic
Follicular and Other Slow Growing Lymphomas Stephen Ansell, MD, PhD Mayo Clinic 1 Learning Objectives Start with an overview of Follicular and other slow growing lymphomas Discuss current and emerging
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:
Réda Bouabdallah, MD Institut Paoli-Calmettes, Marseille, France. Oran, May, 8th, 2010
FIRST LINE TREATMENT IN FOLLICULAR LYMPHOMA Current Status Réda Bouabdallah, MD Institut Paoli-Calmettes, Marseille, France Oran, May, 8th, 2010 FL is a complex disease One disease, but many profiles 20%
Histopathologic results
Self evaluation 1 Clinical Case 55-year-old woman Bilateral enlargement of cervical, axillary and inguinal lymph nodes, largest diameter > 6 cm Hepatosplenomegaly. Enlargement of retroperitoneal, mesenteric
Are CAR T-Cells the Solution for Chemotherapy Refractory Diffuse Large B-Cell Lymphoma? Umar Farooq, MD University of Iowa Hospitals and Clinics
Are CAR T-Cells the Solution for Chemotherapy Refractory Diffuse Large B-Cell Lymphoma? Umar Farooq, MD University of Iowa Hospitals and Clinics Disclosure(s) I do not intend to discuss an off-label use
cancer cancer Hessamfar-Bonarek M et al. Int. J. Epidemiol. 2010;39:135-146
Hematopoietic Stem Cell Transplant in HIV- related lymphoma Song Zhao, MD PhD Hematology-Oncology Program University of Washington/FHCRC Underlying Causes of Death in HIV-infected Adults 2000 2005 cancer
Update on Follicular Lymphoma. Brad Kahl, M.D.
Update on Follicular Lymphoma Brad Kahl, M.D. Follicular Lymphoma: 25% of NHL Cases Other subtypes (9%) T and NK cell (12%) Burkitt (2.5%) Diffuse large B cell (DLBCL) (30%) Mantle cell (6%) Follicular
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; [email protected] (2) Steven
Should we use Docetaxel in hormone- naïve prostate cancer? Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France
Should we use Docetaxel in hormone- naïve prostate cancer? Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France Disclosure Participation to advisory boards/honorarium from: Amgen, Astellas,
SAKK Lung Cancer Group. Current activities and future projects
SAKK Lung Cancer Group Current activities and future projects SAKK Lung Cancer Group Open group of physicians interested in lung cancer Mostly Medical Oncologists, but also Thoracic Surgeons Radiation
亞 東 紀 念 醫 院 Follicular Lymphoma 臨 床 指 引
前 言 : 惡 性 淋 巴 瘤 ( 或 簡 稱 淋 巴 癌 ) 乃 由 體 內 淋 巴 系 統 包 括 淋 巴 細 胞 淋 巴 管 淋 巴 腺 及 一 些 淋 巴 器 官 或 組 織 如 脾 臟 胸 腺 及 扁 桃 腺 等 所 長 出 的 惡 性 腫 瘤 依 腫 瘤 病 理 組 織 型 態 的 不 同 可 分 為 何 杰 金 氏 淋 巴 瘤 (Hodgkin s disease) 與 非 何 杰 金
HOVON Staging and Response Criteria for Non-Hodgkin s Lymphomas Page 1
HOVON Staging and Response Criteria for Non-Hodgkin s Lymphomas Page 1 This document describes the minimally required staging and evaluation procedures and response criteria that will be applied in all
Rituximab Maintenance for 2 Years in Patients with Untreated High Tumor Burden Follicular Lymphoma After Response to Immunochemotherapy
Rituximab Maintenance for 2 Years in Patients with Untreated High Tumor Burden Follicular Lymphoma After Response to Immunochemotherapy G. A. Salles, J. F. Seymour, P. Feugier, F. Offner, A. Lopez-Guillermo,
Hodgkin Lymphoma Disease Specific Biology and Treatment Options. John Kuruvilla
Hodgkin Lymphoma Disease Specific Biology and Treatment Options John Kuruvilla My Disclaimer This is where I work Objectives Pathobiology what makes HL different Diagnosis Staging Treatment Philosophy
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
U.S. Food and Drug Administration
U.S. Food and Drug Administration Notice: Archived Document The content in this document is provided on the FDA s website for reference purposes only. It was current when produced, but is no longer maintained
PET/CT in Lymphoma. Ur Metser, M.D. Division Head, Molecular Imaging Joint Department of Medical Imaging, UHN- MSH- WCH University of Toronto
PET/CT in Lymphoma Ur Metser, M.D. Division Head, Molecular Imaging Joint Department of Medical Imaging, UHN- MSH- WCH University of Toronto Outline 1. Introduction: PET/CT, how does it work? 2.Current
CHAPTER 26 LATE BREAKING DEVELOPMENTS: IMPACT OF ANTI-CD20 MONOCLONAL ANTIBODIES ON LYMPHOMA THERAPY
CHAPTER 26 LATE BREAKING DEVELOPMENTS: IMPACT OF ANTI-CD20 MONOCLONAL ANTIBODIES ON LYMPHOMA THERAPY 26.1 Introduction rituximab Subsequent to the completion of drafts for the guidelines earlier in 2004,
Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs. Case Study. Surgery. Lumpectomy and Radiation
Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs Michael Alvarado, MD Associate Professor of Surgery University of California San Francisco Case Study 59 yo woman with new palpable
Michael Crump MD. Lymphoma Site Leader Princess Margaret Hospital University of Toronto
Evolution of Lymphoma Therapy: What can we expect for the rest of the millenium decade? Michael Crump MD Lymphoma Site Leader Princess Margaret Hospital University of Toronto disclaimers Served on advisory
MALIGNANT LYMPHOMAS. Dr. Olga Vujovic (Updated August 2010)
MALIGNANT LYMPHOMAS Dr. Olga Vujovic (Updated August 2010) Malignant lymphomas consist of Hodgkin and non-hodgkin lymphomas. The current management of these diseases involves a multi-disciplinary approach.
Approccio multidisciplinare nel carcinoma della vescica. D. Amoroso Dip. di Oncologia Medica Ospedale Versilia Lido di Camaiore (LU)
Approccio multidisciplinare nel carcinoma della vescica D. Amoroso Dip. di Oncologia Medica Ospedale Versilia Lido di Camaiore (LU) Disclosures Advisory Role, Honoraria: ü Roche ü Italfarmaco Outline v
What is non-hodgkin lymphoma, how is it treated, and what is the unmet need?
What is non-hodgkin lymphoma, how is it treated, and what is the unmet need? Tim Illidge BSc PhD MRCP FRCR FRCPath Institute of Cancer Sciences, University of Manchester Manchester Cancer Research Centre,
The role of chemotherapy in follicular lymphomas Emanuele Zucca, M.D.
The role of chemotherapy in follicular lymphomas Emanuele Zucca, M.D. Oncology Institute of Southern Switzerland (IOSI) Swiss Group for Clinical Cancer Research (SAKK) WHO grading of follicular lymphoma
How To Predict Prognosis From An Eortc Gb
1 di 5 15/10/2011 9.22 Radiation Oncology/CNS/High grade glioma/overview Front Page: Radiation Oncology RTOG Trials Randomized Trials Glioblastoma and High Grade Gliomas Overview Pathology University of
Mantle Cell Lymphoma Understanding Your Treatment Options
New Developments in Mantle Cell Lymphoma John P. Leonard, M.D. Richard T. Silver Distinguished Professor of Hematology and Medical Oncology Associate Dean for Clinical Research Vice Chairman, Department
David Loew, LCL MabThera
MabThera The star continues to rise David Loew, LCL MabThera MabThera the star continues to raise Group sales (CHF bn) 4,5 4,0 3,5 3,0 2,5 2,0 1,5 1,0 0,5 0,0 2001 2002 2003 2004 2005 Outstanding clinical
Trials in Elderly Melanoma Patients (with a focus on immunotherapy)
Trials in Elderly Melanoma Patients (with a focus on immunotherapy) Where we were Immunotherapy Trials: past and present Relevance for real world practice Where we are SIOG October 2012 James Larkin FRCP
BRAIN CANCER TREATMENT REGIMENS (Part 1 of 5)
BRAIN CANCER TREATMENT REGIMENS (Part 1 of 5) The selection, dosing, and administration of anticancer agents and the management of associated toxicities are complex. Drug dose modifications and schedule
Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda
Stomach (Gastric) Cancer Prof. M K Mahajan ACDT & RC Bathinda Gastric Cancer Role of Radiation Layers of the Stomach Mucosa Submucosa Muscularis Serosa Stomach and Regional Lymph Nodes Stomach and Regional
PROTOCOLS FOR TREATMENT OF MALIGNANT LYMPHOMA
2012 1 31,, PROTOCOLS FOR TREATMENT OF MALIGNANT LYMPHOMA Version 1.0 2012 DIVISION OF HAEMATOLOGY / ONCOLOGY DEPARTMENT OF MEDICINE KAOHSING VETERAN GENERAL HOSPTIAL General Guide Diagnosis 1.Adequate
Rectal Cancer. To Radiate or not to radiate? Q: Should rectal cancer RT/CRT decisions be based solely on stage? 11/09/2014
Rectal Cancer To Radiate or not to radiate?? Dr. Corinne Doll Radiation Oncologist Tom Baker Cancer Centre Calgary, Alberta Q: Should rectal cancer RT/CRT decisions be based solely on stage? 1 Q: Can RT/CRT
ROLE OF RADIATION THERAPY FOR RESECTABLE LUNG CANCER
AFA 08958 From Bench to Bedside From KK DT1 10/27/2015 12:04 PM 01 ROLE OF RADIATION THERAPY FOR RESECTABLE LUNG CANCER Hak Choy, MD University of Texas Southwestern Medical Center Dallas, Texas, USA Orchestrating
Chemobrain. Halle C.F. Moore, MD The Cleveland Clinic October 3, 2015
Chemobrain Halle C.F. Moore, MD The Cleveland Clinic October 3, 2015 Terminology Chemotherapy-associated cognitive dysfunction Post-chemotherapy cognitive impairment Cancer treatment-associated cognitive
Radiotherapy in locally advanced & metastatic NSC lung cancer
Radiotherapy in locally advanced & metastatic NSC lung cancer Dr Raj Hegde. MD. FRANZCR Consultant Radiation Oncologist. William Buckland Radiotherapy Centre. Latrobe Regional Hospital. Locally advanced
the standard of care 2009 5/1/2009 Mesothelioma: The standard of care take home messages PILC 2006 [email protected] Brussels, March 7, 2009
Mesothelioma: The standard of care [email protected] Brussels, March 7, 2009 take home messages PILC 2006 All patients should receive adequate palliation of dyspnea and pain before starting chemotherapy
Characteristics and Prognosis of Patients with Richter s Transformation of Chronic Lymphocytic Leukemia: Experience with FDG/PET
Characteristics and Prognosis of Patients with Richter s Transformation of Chronic Lymphocytic Leukemia: Experience with FDG/PET Lorenzo Falchi, Long Trinh, Edith M Marom, Mylene Truong, Ellen J Schlette,
Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma
Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma Marc de Perrot, Ronald Feld, Natasha B Leighl, Andrew Hope, Thomas K Waddell, Shaf Keshavjee,
Clinical Management Guideline Management of locally advanced or recurrent Renal cell carcinoma. Protocol for Planning and Treatment
Protocol for Planning and Treatment The process to be followed in the management of: LOCALLY ADVANCED OR METASTATIC RENAL CELL CARCINOMA Patient information given at each stage following agreed information
Bendamustine with rituximab for the first-line treatment of advanced indolent non-hodgkin's and mantle cell lymphoma
LONDON CANCER NEW DRUGS GROUP RAPID REVIEW Bendamustine with rituximab for the first-line treatment of advanced indolent non-hodgkin's and mantle cell lymphoma Bendamustine with rituximab for the first-line
Treatment results with Bortezomib in multiple myeloma
Treatment results with Bortezomib in multiple myeloma Prof. Dr. Orhan Sezer Hamburg University Medical Center Circulating proteasome levels are an independent prognostic factor in MM 1.0 Probability of
Diffuse large B-cell lymphoma: the curable disease?
Hematology Meeting Reports 2007; 1(5):77 86 Diffuse large B-cell lymphoma: the curable disease? Michael Pfreundschuh Med Klinik I, Saarland University Medical School, Homburg/Saar, Germany Corresponding
Acute Myeloid Leukemia
Acute Myeloid Leukemia Upfront Therapy in Newly Diagnosed Elderly AML Patients: Is Decitabine (DAC) the new standard? Raoul Tibes, MD, PhD Senior Associate Consultant, Mayo Clinic Arizona Associate Director,
Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate e P rofessor Professor Radiation Oncology
Principles of Radiation Therapy A Bapsi Chakravarthy, MD Associate Professor Radiation Oncology Disclosure Information I have no financial relationships to disclose relevant to the conten of this presentation.
PARP Inhibitors in Lung Cancer. Primo N. Lara, Jr., MD Professor of Medicine UC Davis Comprehensive Cancer Center
PARP Inhibitors in Lung Cancer Primo N. Lara, Jr., MD Professor of Medicine UC Davis Comprehensive Cancer Center Poly (ADP-ribose) Polymerase (PARP): Mechanism of Action PARPs: family of enzymes that repair
Targeted therapies and brain metastases in lung cancer patients. Benjamin Besse, MD, PhD. Medical Oncologist. 19 septembre 2014
Targeted therapies and brain metastases in lung cancer patients Benjamin Besse, MD, PhD Medical Oncologist 19 septembre 2014 Targeted therapies and brain mets! Brain mets in NSCLC! Specific targeted therapies!
Integrating Chemotherapy and Liver Surgery for the Management of Colorectal Metastases
I Congresso de Oncologia D Or July 5-6, 2013 Integrating Chemotherapy and Liver Surgery for the Management of Colorectal Metastases Michael A. Choti, MD, MBA, FACS Department of Surgery Johns Hopkins University
Non-Hodgkin s lymphomas (NHLs) are a
Oncology 33 Non-Hodgkin s lymphoma in the elderly The incidence of non-hodgkin s lymphoma (NHL) is increasing, and this increase is even more rapid in the older population. Although treatment of NHL in
What is the Optimal Front-Line Treatment for mrcc? Michael B. Atkins, MD Deputy Director, Georgetown-Lombardi Comprehensive Cancer Center
What is the Optimal Front-Line Treatment for mrcc? Michael B. Atkins, MD Deputy Director, Georgetown-Lombardi Comprehensive Cancer Center The Case for Immunotherapy in mrcc 1. Achieves patient s goal 2.
PET. Can we afford PET-CT. Positron annihilation. PET-CT scanner. PET detection
PET-CT Can we afford PET-CT John Buscombe New technology Combines functional information-pet anatomical information-ct Machine able to perform both studies in single imaging episode PET imaging depends
Clinical Trials of Lapatinib in Patients with Brain Metastases. Nancy U Lin, MD Dana Farber Cancer Institute March 1, 2009
Clinical Trials of Lapatinib in Patients with Brain Metastases from HER2+ Breast Cancer Nancy U Lin, MD Dana Farber Cancer Institute March 1, 2009 Background ~1/3 of women with HER2+ MBC develop brain
Treatment of Small Cell Lung Cancer: American Society of Clinical Oncology. Endorsement of the American College of Chest Physicians (ACCP) Guideline
Treatment of Small Cell Lung Cancer: American Society of Clinical Oncology Endorsement of the American College of Chest Physicians (ACCP) Guideline Table of Contents Data Supplement 1: Summary of included
Chemotherapy in Ovarian Cancer. Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group
Chemotherapy in Ovarian Cancer Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group Adjuvant chemotherapy for early stage EOC Fewer than 30% women present with FIGO stage
Guidelines for the Management of Follicular Lymphoma
Guidelines for the Management of Follicular Lymphoma Scope The following guidance for first- and second-line therapy applies to follicular lymphoma histological grades 1, 2 and 3a according to the World
DIFFUSE LARGE B-CELL LYMPHOMA
DIFFUSE LARGE B-CELL LYMPHOMA Executive Summary Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-hodgkin lymphoma (NHL), constituting up to 40% of all cases globally.[1] This subtype
Chimeric Antigen Receptor T Cell Therapy
Chimeric Antigen Receptor T Cell Therapy Yi Lin, MD, PhD Mayo Clinic, Rochester, MN Alliance Spring Group Meeting - May 13, 2016 Presentation Objectives l Scientific overview of chimeric antigen receptor
The role of PET-CT in Follicular Lymphoma Prognostic and Predictive
The role of PET-CT in Follicular Lymphoma Prognostic and Predictive Judith Trotman University Sydney Massimo Federico University Modena Menton 2012 How we used to look at FL 1. Indolent B-cell lymphoma
CANCER PULMON: ESTADIOS INICIALES POSTMUNDIAL PULMON DENVER 2015. 8-10-2015.Manuel Cobo Dols S. Oncología Médica HU Málaga Regional y VV
CANCER PULMON: ESTADIOS INICIALES POSTMUNDIAL PULMON DENVER 2015 8-10-2015.Manuel Cobo Dols S. Oncología Médica HU Málaga Regional y VV Meta-analisis LACE: adyuvancia vs no adyuvancia Pignon JP, et al.
Clinical Trials and Radiation Treatment. Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto
Clinical Trials and Radiation Treatment Gerard Morton Odette Cancer Centre Sunnybrook Research Institute University of Toronto What I will cover.. A little about radiation treatment The clinical trials
East Midlands Cancer Network Guidelines for the Management of Follicular NHL
East Midlands Cancer Network Guidelines for the Management of Follicular NHL Written by: Dr Matthew Lyttelton, Professor Martin Dyer, Dr Andrew Haynes Consultation Group: EMCN Haematology NSSG Summary
Two Retroperitoneal Low-Grade B-Cell Lymphoma Successfully Treated With a Combination of Chimeric Anti-CD20 Monoclonal Antibody and CHOP Chemotherapy
Two Retroperitoneal Low-Grade B-Cell Lymphoma Successfully Treated With a Combination of Chimeric Anti-CD20 Monoclonal Antibody and CHOP Chemotherapy Yoichi Kitamura, MD Kazuhiko Hayashi, MD Kazumi Uchida,
Ovarian Cancer and Modern Immunotherapy: Regulatory Strategies for Drug Development
Ovarian Cancer and Modern Immunotherapy: Regulatory Strategies for Drug Development Sanjeeve Bala, MD, MPH Ovarian Cancer Endpoints Workshop FDA White Oak September 3, 2015 Overview Immune agents from
Management of spinal cord compression
Management of spinal cord compression (SUMMARY) Main points a) On diagnosis, all patients should receive dexamethasone 10mg IV one dose, then 4mg every 6h. then switched to oral dose and tapered as tolerated
1. Introduction. 2. Clinical aspects
1. Introduction MabThera (rituximab) is a genetically engineered chimeric mouse/human monoclonal antibody which binds specifically to the transmembrane antigen, CD20. This antigen is located on pre-b-
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.
GLSG/OSHO Study Group. Supported by Deutsche Krebshilfe
GLSG/OSHO Study Group Supported by Deutsche Krebshilfe GLSG/OSHO Study Group Study Concepts Follicular Lymphomas Mantel Cell Lymphomas Waldenstroem s Disease Key Steps in Improving Treatment for Follicular
J Clin Oncol 23:8447-8452. 2005 by American Society of Clinical Oncology INTRODUCTION
VOLUME 23 NUMBER 33 NOVEMBER 20 2005 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T New Treatment Options Have Changed the Survival of Patients With Follicular Lymphoma Richard I. Fisher, Michael
Chemoimmunotherapy resistant follicular lymphoma A single institutional study
Cancer Research Journal 2014; 2(5): 93-97 Published online September 30, 2014 (http://www.sciencepublishinggroup.com/j/crj) doi: 10.11648/j.crj.20140205.13 ISSN: 2330-8192 (Print); ISSN: 2330-8214 (Online)
TRATTAMENTO COMBINATO RADIO- CHEMIOTERAPICO NEL III STADIO NSCLC
TRATTAMENTO COMBINATO RADIO- CHEMIOTERAPICO NEL III STADIO NSCLC Dr.ssa Sara Ramella Radioterapia Oncologica Campus Bio-Medico Trimodality therapy offers a promising chance of long-term survival Evidenze
Outline of thesis and future perspectives.
Outline of thesis and future perspectives. This thesis is divided into two different sections. The B- section involves reviews and studies on B- cell non- Hodgkin lymphoma [NHL] and radioimmunotherapy
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
Neoadjuvant therapy are we doing it right? Short course and chemoradiation
Neoadjuvant therapy are we doing it right? Short course and chemoradiation Rob Glynne-Jones Mount Vernon Cancer Centre Relevant Endpoints in rectal cancer Local recurrence Disease-free survival Overall
Lymphoma. Measurability of Quality Performance Indicators Version 2.0
Lymphoma Measurability of Quality Performance Indicators Version 2.0 To be read in conjunction with: Lymphoma Clinical Quality Performance Indicators (September 2013) Lymphoma Data Definitions V2.0 (September
Re irradiation Using HDR Interstitial Brachytherapy for Locally Recurrent. Disclosure
Re irradiation Using HDR Interstitial Brachytherapy for Locally Recurrent Cervical lcancer Yasuo Yoshioka, MD Department of Radiation Oncology Osaka University Graduate School of Medicine Osaka, Japan
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.
Difúzny veľkobunkový lymfóm
Hlavná téma 73 Difúzny veľkobunkový lymfóm MUDr. Michaela Sojáková, MUDr. Andrej Vranovský, PhD. Oddelenie klinickej hematológie a transfuziológie, Národný onkologický ústav, Bratislava Difúzny veľkobunkový
Sonneveld, P; de Ridder, M; van der Lelie, H; et al. J Clin Oncology, 13 (10) : 2530-2539 Oct 1995
Comparison of Doxorubicin and Mitoxantrone in the Treatment of Elderly Patients with Advanced Diffuse Non-Hodgkin's Lymphoma Using CHOP Versus CNOP Chemotherapy. Sonneveld, P; de Ridder, M; van der Lelie,
Implementation Date: April 2015 Clinical Operations
National Imaging Associates, Inc. Clinical guideline PROSTATE CANCER Original Date: March 2011 Page 1 of 5 Radiation Oncology Last Review Date: March 2015 Guideline Number: NIA_CG_124 Last Revised Date: