Background: Treatment refractory metastatic breast cancer patients are at best treated palliatively. We evaluated the effects of metronomic chemotherapy on survival outcomes in this population. Methods: Twenty eight s...Background: Treatment refractory metastatic breast cancer patients are at best treated palliatively. We evaluated the effects of metronomic chemotherapy on survival outcomes in this population. Methods: Twenty eight subjects with treatment refractory (n = 21) and treatment naive (n = 7) MBC were included in an open label single arm efficacy study of metronomic chemotherapy. Patients were given a chemotherapy regimen of Tab. Cyclophosphamide 50 mg once daily and Tab. Methotrexate 2.5 mg twice in a week over a minimum period of 3 months or until the progression of their disease whichever was earlier. Monitoring of serum VEGF and Thrombospondin levels were done to correlate the response rates. Data were analysed using chi square test for proportions and Kaplan Meir Survival analysis. Results: The mean age of the study population was 51.5 ± 14.2 years. The mean duration of metronomic chemotherapy was 123.89 ± 97.6 days. Overall 71.4% had progressive disease and 28.6% had stable disease. 55.6% with treatment naive metastatic breast cancer had stable disease compared to 15.8% of treatment refractory metastatic breast cancer. There was also a significant improvement in progression free survival in those with tumor load less than 5 cms compared to >5 cms and in grade 2 compared to grade 3 disease. There was no correlation of serum VEGF levels before and after chemotherapy. There is no significant decrease in TSP levels. Conclusion: The results suggest stable response in one third of study patients. Performance status and tumor load are important predictors in this category of population. There is no significant correlation of serum VEGF and TSP levels before and after chemotherapy. Also, there was no significant correlation of biomarker levels in responding and non-responding patients.展开更多
Introduction: Immunotherapy is also called as biologic therapy or bio-therapy. Immunotherapy is quickly becoming an important component in the multipronged approaches being developed to treat certain forms of cancer. ...Introduction: Immunotherapy is also called as biologic therapy or bio-therapy. Immunotherapy is quickly becoming an important component in the multipronged approaches being developed to treat certain forms of cancer. The goal of immunotherapy is to strengthen the body’s own natu-ral ability to combat cancer by enhancing the effectiveness of the immune system. This study tries to compile response rates and side effect profile of Nivolumab. Methods: Patients with performance status of 3 or less than 3, who failed on 2 or more lines of therapy except melanoma and have received minimum 3 cycles of Nivolumab were taken in to this study. Study subjects followed for minimum of 3 cycles for assessment. Each patient received 240 mg of Nivolumab once in 15 days for 3 - 6 cycles. Results: The median age of 20 patients was 53 years (26 - 79 yrs). 18 patients were male and 2 patients were female. Progressive disease (PD) was observed in 12 patients with immunotherapy treatment and partial response (PR) was observed in 3 patients, and stable disease (SD) in 5 patients. Conclusion: This is one of the Indian study mainly reporting experiences with Nivolumab. Large sample size is required to conclude about the efficacy of the study. Nivolumab is more tolerated in Indian patients compared to other reported studies.展开更多
Background: Lung cancer is the leading cause of cancer-related death worldwide with an estimated 1.6 million new cases diagnosed each year. According to standard guidelines in NSCLC, the effectiveness of combined chem...Background: Lung cancer is the leading cause of cancer-related death worldwide with an estimated 1.6 million new cases diagnosed each year. According to standard guidelines in NSCLC, the effectiveness of combined chemotherapy regimen comprises of pemetrexed and platinum, and very few reports are available in Indian population. This study shows the experience with pemetrexed and platinum combination chemotherapy in metastatic NSCLC in first line setting. Methods: Total 61 patients with following inclusion criteria were recruited such as: 1) PS of 1 and 2;2) NSCLC of non-squamous histology;3) locally advanced or metastatic disease at diagnosis;4) should have received minimum 3 cycles of pemetrexed and platinum as first line treatment and or continued for 6 cycles;5) EGFR/ALK mutated or EGFR/ALK unknown patients but must have received upfront chemo. Primary endpoint of the present study is to assess Disease Control Rate (DCR) (CR + PR + SD). Progression Free Survival, OS and Toxicity assessment were secondary endpoints. Results: The mean number of average chemotherapy cycles was found to be 4.38. The range of chemotherapy was 2 - 6 cycles. Disease control rate, defined as (CR + PR + SD), was seen in 44 (72.1%) patients. (PR in 26 (42.62%), SD 18 (29.5%)), Progressive disease (PD) was observed in 17 (27.9%) patients. Overall study showed that patients had PFS of 9.414 months (95% CI 6.709 - 12.120) and OS of 13.437 months (95% CI 10.721 - 16.153). Conclusion: Pemetrexed and platinum combination is effective and well-tolerated chemotherapy regimen in patients with metastatic adenocarcinoma lung cancer patients. Pemetrexed and cisplatin may be more effective in particular. Early switch over to TKIs is preferred immediately after obtaining molecular subtype result.展开更多
文摘Background: Treatment refractory metastatic breast cancer patients are at best treated palliatively. We evaluated the effects of metronomic chemotherapy on survival outcomes in this population. Methods: Twenty eight subjects with treatment refractory (n = 21) and treatment naive (n = 7) MBC were included in an open label single arm efficacy study of metronomic chemotherapy. Patients were given a chemotherapy regimen of Tab. Cyclophosphamide 50 mg once daily and Tab. Methotrexate 2.5 mg twice in a week over a minimum period of 3 months or until the progression of their disease whichever was earlier. Monitoring of serum VEGF and Thrombospondin levels were done to correlate the response rates. Data were analysed using chi square test for proportions and Kaplan Meir Survival analysis. Results: The mean age of the study population was 51.5 ± 14.2 years. The mean duration of metronomic chemotherapy was 123.89 ± 97.6 days. Overall 71.4% had progressive disease and 28.6% had stable disease. 55.6% with treatment naive metastatic breast cancer had stable disease compared to 15.8% of treatment refractory metastatic breast cancer. There was also a significant improvement in progression free survival in those with tumor load less than 5 cms compared to >5 cms and in grade 2 compared to grade 3 disease. There was no correlation of serum VEGF levels before and after chemotherapy. There is no significant decrease in TSP levels. Conclusion: The results suggest stable response in one third of study patients. Performance status and tumor load are important predictors in this category of population. There is no significant correlation of serum VEGF and TSP levels before and after chemotherapy. Also, there was no significant correlation of biomarker levels in responding and non-responding patients.
文摘Introduction: Immunotherapy is also called as biologic therapy or bio-therapy. Immunotherapy is quickly becoming an important component in the multipronged approaches being developed to treat certain forms of cancer. The goal of immunotherapy is to strengthen the body’s own natu-ral ability to combat cancer by enhancing the effectiveness of the immune system. This study tries to compile response rates and side effect profile of Nivolumab. Methods: Patients with performance status of 3 or less than 3, who failed on 2 or more lines of therapy except melanoma and have received minimum 3 cycles of Nivolumab were taken in to this study. Study subjects followed for minimum of 3 cycles for assessment. Each patient received 240 mg of Nivolumab once in 15 days for 3 - 6 cycles. Results: The median age of 20 patients was 53 years (26 - 79 yrs). 18 patients were male and 2 patients were female. Progressive disease (PD) was observed in 12 patients with immunotherapy treatment and partial response (PR) was observed in 3 patients, and stable disease (SD) in 5 patients. Conclusion: This is one of the Indian study mainly reporting experiences with Nivolumab. Large sample size is required to conclude about the efficacy of the study. Nivolumab is more tolerated in Indian patients compared to other reported studies.
文摘Background: Lung cancer is the leading cause of cancer-related death worldwide with an estimated 1.6 million new cases diagnosed each year. According to standard guidelines in NSCLC, the effectiveness of combined chemotherapy regimen comprises of pemetrexed and platinum, and very few reports are available in Indian population. This study shows the experience with pemetrexed and platinum combination chemotherapy in metastatic NSCLC in first line setting. Methods: Total 61 patients with following inclusion criteria were recruited such as: 1) PS of 1 and 2;2) NSCLC of non-squamous histology;3) locally advanced or metastatic disease at diagnosis;4) should have received minimum 3 cycles of pemetrexed and platinum as first line treatment and or continued for 6 cycles;5) EGFR/ALK mutated or EGFR/ALK unknown patients but must have received upfront chemo. Primary endpoint of the present study is to assess Disease Control Rate (DCR) (CR + PR + SD). Progression Free Survival, OS and Toxicity assessment were secondary endpoints. Results: The mean number of average chemotherapy cycles was found to be 4.38. The range of chemotherapy was 2 - 6 cycles. Disease control rate, defined as (CR + PR + SD), was seen in 44 (72.1%) patients. (PR in 26 (42.62%), SD 18 (29.5%)), Progressive disease (PD) was observed in 17 (27.9%) patients. Overall study showed that patients had PFS of 9.414 months (95% CI 6.709 - 12.120) and OS of 13.437 months (95% CI 10.721 - 16.153). Conclusion: Pemetrexed and platinum combination is effective and well-tolerated chemotherapy regimen in patients with metastatic adenocarcinoma lung cancer patients. Pemetrexed and cisplatin may be more effective in particular. Early switch over to TKIs is preferred immediately after obtaining molecular subtype result.
