José Luis Martín-Varillas, Belén Atienza-Mateo, Vanesa Calvo-Rio, Emma Beltrán, Juan Sánchez-Bursón, Alfredo Adán, Marisa Hernández-Garfella, Elia Valls-Pascual, Agustí Sellas-Fernández, Norberto Ortego, Olga Maíz, Ignacio Torre, Cruz Fernández-Espartero, Vega Jovani, Diana Peiteado, David Díaz Valle, Elena Aurrecoechea, Miguel A Caracuel, Alfredo J García-González, Enrique Raya Álvarez, Nuria Vegas-Revenga, Rosalía Demetrio-Pablo, Santos Castañeda, Miguel A González-Gay, José Luis Hernández, Ricardo Blanco
OBJECTIVE: In a large series of Caucasian patients with refractory uveitis due to Behçet disease (BD) treated with infliximab (IFX) we assessed: a) long-term efficacy and safety and b) IFX optimization when ocular remission was achieved. METHODS: Multicenter study of IFX-treated patients with BD uveitis refractory to conventional immunosuppressant agents.103 patients/185 affected eyes were treated with IFX as first biologic therapy as follows: 3-5 mg/kg i.v. at 0, 2, 6 and then every 4-8 weeks...
October 1, 2020: Journal of Rheumatology
Nabil Seery, Vivien Li, Ai-Lan Nguyen, Izanne Roos, Katherine A Buzzard, Roberts Atvars, Nicola Taylor, Kelsey Tunnell, John Carey, Chris Dwyer, Hasini Fernandoa Lisa Taylor, Josephine Baker, Mark P Marriott, Trevor J Kilpatrick, Tomas Kalincik, Mastura Monif
OBJECTIVE: Patients with Multiple Sclerosis (MS) and on disease modifying therapies (DMTs) that can be immunosuppressive or immunomodulatory form a special group where risk of continuation of DMT needs to be taken into account with risk of contracting Covid-19. This concept can pose a degree of anxiety for patients as well as neurologists. We aimed to evaluate patient perspectives regarding the use of Natalizumab and anti-CD20 therapies (Rituximab and Ocrelizumab) in the context of the COVID-19 pandemic...
September 16, 2020: Multiple Sclerosis and related Disorders
Matthew Loft, Hui-Li Wong, Suzanne Kosmider, Margaret Lee, Jeanne Tie, Rachel Wong, Ian T Jones, Matthew Croxford, Malcolm Steel, Ian Faragher, Mario Guerrieri, Michael Christie, Peter Gibbs
BACKGROUND: Neoadjuvant chemoradiation therapy (CRT) is standard of care treatment for locally advanced rectal cancer (LARC). A pathologic complete response (pCR) following CRT is an early indicator of treatment benefit and associated with excellent survival outcomes. As capecitabine replaces infusional 5-fluorouracil (5-FU) as the fluoropyrimidine of choice in routine care of LARC, on the back of clinical trial data demonstrating equivalence, it is important to confirm that efficacy is maintained in the real-world setting...
September 8, 2020: Internal Medicine Journal
Chiara Cremolini, Carlotta Antoniotti, Alexander Stein, Johanna Bendell, Thomas Gruenberger, Daniele Rossini, Gianluca Masi, Elena Ongaro, Herbert Hurwitz, Alfredo Falcone, Hans-Joachim Schmoll, Massimo Di Maio
PURPOSE: A proper estimation of the magnitude of the overall survival (OS) benefit from infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) plus bevacizumab versus doublets + bevacizumab is lacking because all trials that have investigated this regimen had primary end points other than OS. To test OS with higher power and to explore the interaction of treatment effect with main patient and disease characteristics, we performed an individual patient data (IPD) meta-analysis...
August 20, 2020: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Chong Chyn Chua, Andrew W Roberts, John Reynolds, Chun Yew Fong, Stephen B Ting, Jessica M Salmon, Sarah MacRaild, Adam Ivey, Ing Soo Tiong, Shaun Fleming, Fiona C Brown, Sun Loo, Ian J Majewski, Stefan K Bohlander, Andrew H Wei
PURPOSE: The B-cell lymphoma 2 (BCL-2) inhibitor venetoclax has an emerging role in acute myeloid leukemia (AML), with promising response rates in combination with hypomethylating agents or low-dose cytarabine in older patients. The tolerability and efficacy of venetoclax in combination with intensive chemotherapy in AML is unknown. PATIENTS AND METHODS: Patients with AML who were ≥ 65 years (≥ 60 years if monosomal karyotype) and fit for intensive chemotherapy were allocated to venetoclax dose-escalation cohorts (range, 50-600 mg)...
July 20, 2020: Journal of Clinical Oncology
Blessie Nelson, Angelina Hong, Fatima Iqbal, Rohit Venkatesan
Plasmablastic lymphoma (PBL) is a rare form of non-Hodgkin lymphoma that is highly aggressive and carries a poor prognosis. Although the standard chemotherapy choice for most diffuse large B-cell lymphomas (DLBCL) is R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), subtypes of DLBCL such as PBL are less responsive to this treatment regimen. The preferred regimens for PBL include infusional EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin hydrochloride), HyperCVAD (cyclophosphamide, vincristine sulfate, doxorubicin hydrochloride, and dexamethasone), or CODOX-M/IVAC (cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, and high-dose cytarabine)...
June 15, 2020: Curēus
Francine M Foss, Xin Victoria Wang, Selina M Luger, Opeyemi Jegede, Kenneth B Miller, Edward A Stadtmauer, Theresa L Whiteside, David E Avigan, Randall D Gascoyne, Daniel Arber, Henry Wagner, Roger K Strair, William J Hogan, Kellie A Sprague, Hillard M Lazarus, Mark R Litzow, Martin S Tallman, Sandra J Horning
BACKGROUND: Extracorporeal photopheresis (ECP) is an immunomodulatory cellular therapy which has been shown to induce a tolerogenic state in patients with acute and chronic graft-vs-host disease. ECOG-ACRIN explored the activity of ECP as a part of a reduced intensity conditioning regimen in two multicenter trials in patients with MDS (E1902) and lymphomas (E1402). While both studies closed before completing accrual, we report results in 23 patients (17 MDS and 6 lymphoma). STUDY DESIGN AND METHODS: Patients received 2 days of ECP followed by pentostatin 4 mg/m2 /day for two consecutive days, followed by 600 cGy of total body irradiation prior to stem cell infusion...
July 12, 2020: Transfusion
Minoru Kobayashi, Ryuichiro Sato, Toshihiro Komura, Hidetaka Ichikawa, Tomoaki Hirashima, Satoshi Otake, Naoya Akazawa, Takashi Yazawa, Tomoya Abe, Takaho Okada, Tetsuya Kakita, Masaya Oikawa, Takashi Tsuchiya
BACKGROUND: Oxaliplatin, one of the key cytotoxic drugs for colorectal cancer, frequently causes peripheral neuropathy which leads to dose modification and decreased patients' quality of life. However, prophylactic or therapeutic measures have not yet been established. Orally administered amino acids, cystine and theanine, promoted the synthesis of glutathione which was one of the potential candidates for preventing the neuropathy. The aim of this study was to determine whether daily oral administration of cystine and theanine attenuated oxaliplatin-induced peripheral neuropathy (OXLIPN)...
June 27, 2020: International Journal of Clinical Oncology
Masashi Sawada, Akiyoshi Kasuga, Takafumi Mie, Takaaki Furukawa, Takanobu Taniguchi, Koshiro Fukuda, Yuto Yamada, Tsuyoshi Takeda, Ryo Kanata, Masato Matsuyama, Takashi Sasaki, Masato Ozaka, Naoki Sasahira
BACKGROUND: There is no established second-line treatment after failure of gemcitabine plus nab-paclitaxel (GnP) therapy for metastatic pancreatic cancer (MPC). The purpose of this study was to evaluate the efficacy and tolerability of the modified FOLFIRINOX (mFFX) as a second-line therapy for MPC and to investigate prognostic factors for survival. METHODS: From 2015 to 2019, we retrospectively reviewed the medical records of consecutive patients receiving mFFX for MPC after failure of GnP therapy...
May 20, 2020: BMC Cancer
Faouzi Djebbari, Kanchana De Abrew, Beena Salhan, Fotios Panitsas, Md Imran Hossain, Toby A Eyre, John Willan, Karthik Ramasamy, Supratik Basu, Matthew Jenner, Jaimal Kothari
The use of dexamethasone plus thalidomide in combination with a continuous infusion of cisplatin, doxorubicin, cyclophosphamide, and etoposide (DTPACE) was first described in relapsed myeloma (MM) and showed effectiveness as induction therapy before autologous stem cell transplant (ASCT)1 . The addition of bortezomib to DTPACE (VTDPACE) led to improved outcomes2,3 . Historical indications for DPACE-based therapies include salvage treatment of aggressive MM, plasma cell leukaemia, and initial presentation with extra-medullary disease...
April 8, 2020: European Journal of Haematology
Richard D Kim, Shannon McDonough, Anthony B El-Khoueiry, Tanios S Bekaii-Saab, Stacey M Stein, Vaibhav Sahai, George P Keogh, Edward J Kim, Ari D Baron, Abby B Siegel, Afsaneh Barzi, Katherine A Guthrie, Milind Javle, Howard Hochster
BACKGROUND: The rationale for the evaluation of trametinib in advanced biliary cancer (BC) is based on the presence of mitogen-activated protein kinase alterations and on earlier promising results with MEK inhibitors in BC. METHODS: Patients with histologically proven BC who progressed on gemcitabine/platinum were randomised to trametinib daily (arm 1) versus fluoropyrimidine therapy (infusional 5-fluorouracil or oral capecitabine, arm 2). The primary end-point was overall survival (OS)...
May 2020: European Journal of Cancer
Belén Rodríguez de Castro, Rubén Pampín Sánchez, Sonia Tembrás Martinez, Aitor Ayastuy Ruiz, Cristina Martínez-Múgica Barbosa
BACKGROUND: Disease-modifying therapies for multiple sclerosis have been developed tremendously over the last two decades. OBJECTIVE: The aim of this study was to review the short-, medium-, and long-term safety of alemtuzumab in relapsing remitting multiple sclerosis (RRMS). METHOD: This retrospective observational study (2015-2019) included all patients with highly active or rapidly progressing and aggressive RRMS who were treated with alemtuzumab at the Cabueñes University Hospital...
March 5, 2020: International Journal of Risk & Safety in Medicine
Joseph A Sparano, Jeannette Y Lee, Lawrence D Kaplan, Juan Carlos Ramos, Richard F Ambinder, William Wachsman, David Aboulafia, Ariela Noy, David H Henry, Lee Ratner, Ethel Cesarman, Amy Chadburn, Ronald Mitsuyasu
Four cycles of rituximab plus CHOP chemotherapy is as effective as 6 cycles in low-risk diffuse large B-cell lymphoma (DLBCL). Here we report a post-hoc analysis of a prospective clinical trial in patients with HIV-associated DLBCL and high-grade lymphoma treated with 4-6 cycles of EPOCH plus rituximab based a response-adapted treatment strategy. 106 evaluable patients with HIV-associated DLBCL or high-grade CD20-positive non-Hodgkin's lymphoma were randomized to receive rituximab (375 mg/m2) given either concurrently prior to each infusional EPOCH cycle, or sequentially (weekly for 6 weeks) following completion of EPOCH...
February 27, 2020: Haematologica
Joanne Kurtzberg, Susan Prockop, Sonali Chaudhury, Biljana Horn, Eneida Nemecek, Vinod Prasad, Prakash Satwani, Pierre Teira, Jack Hayes, Elizabeth Burke
Clinical outcomes in children with steroid-refractory acute graft-versus-host disease (SR-aGVHD) are generally poor, with a high mortality rate and limited therapeutic options. Here we report our updated investigational experience with mesenchymal stromal cell (MSC) therapy with remestemcel-L in a multicenter expanded access protocol ( identifier NCT00759018) in 241 children with aGVHD who failed to respond to steroids with or without other secondary and tertiary immunosuppressive therapies...
February 7, 2020: Biology of Blood and Marrow Transplantation
Antonio Pecoraro, Silvia Ricci, Alessandra Vultaggio, Giorgio Maria Boggia, Giuseppe Spadaro
BACKGROUND AND OBJECTIVE: In recent years, two Italian non-interventional studies evaluated subcutaneous immunoglobulin (SCIG) treatment in patients affected by primary antibody deficiency (PAD). The SHIFT study considered patients who were treated with intravenous immunoglobulin (IVIG) or SCIG 16% (Vivaglobin® ) and then replaced this therapy with weekly treatments of SCIG 20% (Hizentra® ). The IBIS study evaluated patients previously taking a weekly SCIG 20% regimen, who instead began therapy with biweekly SCIG 20% to assess the correlation between the dose of immunoglobulin G (IgG) administered and the body mass index (BMI) of patients, determine if there is a need for dosage adjustments on a BMI basis, and identify the predictors of serum IgG trough levels in our cohort...
February 8, 2020: Clinical Drug Investigation
Till Braun, Jana von Jan, Linus Wahnschaffe, Marco Herling
PURPOSE OF REVIEW: T cell prolymphocytic leukemia (T-PLL) is a rare mature T cell tumor. Available treatment options in this aggressive disease are largely inefficient and patient outcomes are highly dissatisfactory. Current therapeutic strategies mainly employ the CD52-antibody alemtuzumab as the most active single agent. However, sustained remissions after sole alemtuzumab-based induction are exceptions. Responses after available second-line strategies are even less durable. More profound disease control or rare curative outcomes can currently only be expected after a consolidating allogeneic hematopoietic stem cell transplantation (allo-HSCT) in best first response...
April 2020: Current Hematologic Malignancy Reports
Kenneth L Kehl, Michael J Hassett, Deborah Schrag
BACKGROUND: Historically, older patients with advanced lung cancer have often received no systemic treatment. Immunotherapy has improved outcomes in clinical trials, but its dissemination and implementation at the population level is not well-understood. METHODS: A retrospective cohort study of patients with stage IV non-small cell lung cancer (NSCLC) diagnosed age 66 or older from 2012 to 2015 was conducted using SEER-Medicare. Treatment patterns within one year of diagnosis were ascertained...
January 27, 2020: Cancer Medicine
Mary Thompson, Shirley H J Mei, Dianna Wolfe, Josée Champagne, Dean Fergusson, Duncan J Stewart, Katrina J Sullivan, Emily Doxtator, Manoj Lalu, Shane W English, John Granton, Brian Hutton, John Marshall, Alies Maybee, Keith R Walley, Claudia Dos Santos, Brent Winston, Lauralyn McIntyre
Background: Characterization of the mesenchymal stromal cell (MSC) safety profile is important as this novel therapy continues to be evaluated in clinical trials for various inflammatory conditions. Due to an increase in published randomized controlled trials (RCTs) from 2012-2019, we performed an updated systematic review to further characterize the MSC safety profile. Methods: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science (to May 2018) were searched...
February 2020: EClinicalMedicine
Emma C Fields, Brian J Kaplan, Jeremy Karlin, Jennifer L Myers, Nitai Mukhopadhyay, Xiaoyan Deng, Heidi Sankala, Steven R Grossman, Khalid Matin
Purpose: To assess the safety and feasibility of neoadjuvant short-course radiation therapy (RT) concurrent with continuous infusion 5-fluorouracil (5-FU) for the treatment of locally advanced rectal cancer. Methods and Materials: Patients with cT3-4 or N + rectal adenocarcinoma based on ultrasound or magnetic resonance imaging were prospectively enrolled in this study. Study treatment consisted of continuous infusion 5-FU combined with short-course RT (5 Gy x 5 fractions) followed by 4 cycles of mFOLFOX, total mesorectal excision (TME), and 6 cycles of adjuvant mFOLFOX...
October 2019: Advances in Radiation Oncology
Mayela Mendt, Katayoun Rezvani, Elizabeth Shpall
Mesenchymal stem/stromal cells (MSCs) are commonly used as a source of cellular therapy due to their strong immunosuppressive and regenerative effects. One of the key mechanisms of MSC efficacy appears to derive from their paracrine activity. Recently, it has been shown that the secretion of different factors through extracellular vesicles known as exosomes, orchestrate the principle mechanisms of action of MSCs after infusion. The use of MSC-derived exosomes may provide considerable advantages over their counterpart live cells, potentially reducing undesirable side effects including infusional toxicities...
August 2019: Bone Marrow Transplantation
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