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1.
Hematol Oncol Stem Cell Ther ; 11(1): 30-33, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29100977

ABSTRACT

OBJECTIVE: To evaluate the effectiveness and tolerability of neoadjuvant chemotherapy with weekly paclitaxel in combination with weekly carboplatin area under curve 2 followed by anthracycline chemotherapy. PATIENTS AND METHODS: This is a retrospective review of electronic medical records of patients (N = 32) with stage 1c-III triple-negative breast cancer. Patients received neoadjuvant chemotherapy with paclitaxel 80 mg/m2 once per week for 12 weeks in combination with carboplatin area under curve 2 once per week for 12 weeks (wP + wCb), followed by a standard anthracycline regimen including either doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2 every 2 or 3 weeks, or epirubicin 90 mg/m2 and cyclophosphamide 600 mg/m2 every 3 weeks for four cycles with myeloid growth factor support. RESULTS: Most patients (91%) received all 12 cycles of wP + wCb, and 88% received all four planned cycles of anthracycline chemotherapy. Of the patients, 84% completed all planned therapies. The complete pathologic response rate was 60%. In terms of hematologic toxicity, 96% of the patients experienced grade ≥3 leucopenia, 40% grade ≥3 anemia, and 15% grade ≥3 thrombocytopenia, and neutropenic fever was seen in 22% of the patients. CONCLUSION: The combination of neoadjuvant chemotherapy with wP + wCb before anthracycline chemotherapy can be tolerated by patients with triple-negative breast cancer. Complete pathologic response rates were comparable with those historically seen. Careful selection of patients is fundamental as this regimen is associated with a high incidence of hematologic toxicity.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Neoadjuvant Therapy , Triple Negative Breast Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carboplatin/administration & dosage , Carboplatin/adverse effects , Cyclophosphamide/administration & dosage , Cyclophosphamide/adverse effects , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Female , Humans , Medical Records Systems, Computerized , Paclitaxel/administration & dosage , Paclitaxel/adverse effects , Retrospective Studies , Triple Negative Breast Neoplasms/pathology
2.
Expert Rev Anticancer Ther ; 10(3): 377-86, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20214519

ABSTRACT

Nasopharyngeal carcinoma is a rare malignancy with an incidence well under one per 100,000 person-years, except for some geographic areas, such as Asia. The prognosis of nasopharyngeal carcinoma is related to its potential for locoregional invasion and metastatic spread. Radiotherapy alone remains the standard treatment for early stages. However, for locally advanced disease, chemotherapy may offer some benefit as a radiosensitizer while treating microscopic spread disease. Chemoradiotherapy is now the standard treatment for locally advanced and/or node-positive patients. Platinum-based therapy is the preferred regimen for this therapeutic approach. In this review, we discuss all treatment modalities available for nasopharyngeal carcinoma, including the standard of care and what therapeutic options could be available for those patients who progress after the standard treatment has been delivered.


Subject(s)
Antineoplastic Agents/pharmacology , Nasopharyngeal Neoplasms/therapy , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Disease Progression , Humans , Lymphatic Metastasis/pathology , Nasopharyngeal Neoplasms/epidemiology , Nasopharyngeal Neoplasms/pathology , Neoplasm Metastasis , Prognosis , Radiation-Sensitizing Agents/therapeutic use , Treatment Outcome
3.
Clin Lung Cancer ; 10(2): 91-8, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19362951

ABSTRACT

Carcinogenesis is a complex pathological process induced by abnormalities in the genome, cell-cycle dysregulation, loss of the programmed cell death process, and upregulation of oncogenic pathways associated with proliferation, migration, and survival, among others. Despite recent advances in molecular and tumor biology in non-small-cell lung cancer (NSCLC) and the introduction of several targeted agents, the disease continues to have a dismal survival. Nonetheless, the future looks promising; conventional cytotoxic chemotherapy regimens in combination with targeted agents have shown better response rates and survival than those seen in the past. These targeted agents have the advantage of blocking or inhibiting specific pathways necessary for tumor growth, proliferation, and metastases, without significantly affecting quality of life by having an acceptable toxicity profile. Thus, these novel agents harbor a hope in the treatment of NSCLC and many other malignant diseases when they can be used either in combination with other chemotherapy drugs in several lines of treatment or as a single agent in maintenance therapy until progression of disease, or even more attractively, in combination with other targeted agents themselves. In this review, we discuss second-line treatments for patients who have NSCLC, including targeted agents and their development in this specific setting as part of our armamentarium in lung cancer.


Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Salvage Therapy , Carcinoma, Non-Small-Cell Lung/pathology , Humans , Lung Neoplasms/pathology
4.
Clin Adv Hematol Oncol ; 6(9): 666-72, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18827789

ABSTRACT

Anthracyclines are integral components of most adjuvant chemotherapy regimens for surgically removed early breast cancer and are central to the accepted treatment standards. Recently the standard anthracycline regimen of doxorubicin plus cyclophosphamide was found to be inferior in preventing recurrence of breast cancer when compared to cyclophosphamide and docetaxel, questioning the necessity to expose patients to the potential cardiotoxicity of anthracycline in the adjuvant setting. Trastuzumab, a humanized monoclonal antibody against the extracellular domain of the human epidermal growth factor receptor 2 (HER2) has become the cornerstone of treatment of breast cancers that overexpress HER2 in the neo-adjuvant and metastatic setting. Unfortunately, the combination of anthracyclines and trastuzumab produces a high incidence of cardiotoxicity as seen in early trials of metastatic breast cancer. Five adjuvant trials combining trastuzumab with different anthracycline-based regimens have been reported, all of them revealing similar efficacy in reducing recurrence of breast cancer. The trastuzumab adjuvant trial 006 from the Breast Cancer International Research Group shows for the first time that a nonanthracycline-containing regimen with trastuzumab has equivalent efficacy in decreasing the recurrence of breast cancer, with less incidence of cardiotoxicity when compared to anthracycline-containing trastuzumab adjuvant regimens. Further trials are needed to determine the optimal length of adjuvant therapy with trastuzumab, as well as long-term side effects with special attention to cardiotoxicity.


Subject(s)
Anthracyclines/therapeutic use , Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Heart Diseases/chemically induced , Receptor, ErbB-2/metabolism , Anthracyclines/administration & dosage , Anthracyclines/adverse effects , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Antigens, Neoplasm/metabolism , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Breast Neoplasms/complications , Breast Neoplasms/metabolism , Chemotherapy, Adjuvant , Clinical Trials as Topic , DNA Topoisomerases, Type II/metabolism , DNA-Binding Proteins/metabolism , Humans , Trastuzumab
5.
Expert Rev Anticancer Ther ; 8(3): 443-52, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18366291

ABSTRACT

Breast cancer remains the second leading cause of malignancy-related death in women in the USA, regardless of advances in novel therapeutic agents. High priority should be given to research aimed at the study of pharmacological and natural compounds that could potentially prevent the development of breast cancer in susceptible patients. Tamoxifen has been shown to reduce the incidence of estrogen receptor-positive invasive breast cancer in women with a high risk of developing this condition by nearly 50%, and studies in osteoporosis have revealed a similar protective effect of raloxifene in postmenopausal women. The aromatase inhibitors are superior to tamoxifen in reducing the recurrence of breast cancer in postmenopausal women; large clinical trials are currently evaluating the chemopreventive effect of these agents. The list of agents with the potential for chemoprevention in breast cancer is extensive and continues to expand. There is an immense need to develop drugs that will decrease the incidence of estrogen receptor-negative breast cancer in women at high risk of developing the disease. Herein, we review the most important chemopreventive agents in breast cancer and clinical trials that have evaluated their efficacy.


Subject(s)
Anticarcinogenic Agents , Breast Neoplasms/prevention & control , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Anticarcinogenic Agents/therapeutic use , Aromatase Inhibitors/therapeutic use , Breast Neoplasms/surgery , Carotenoids/therapeutic use , Chemoprevention , Female , Gonadotropin-Releasing Hormone/agonists , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Phytoestrogens/therapeutic use , Raloxifene Hydrochloride/therapeutic use , Selective Estrogen Receptor Modulators/therapeutic use , Tamoxifen/therapeutic use
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