ABSTRACT
Two patients presented with transient thyrotoxicosis within 2-4 weeks after starting treatment with nivolumab. This thyrotoxicosis turned into hypothyroidism within 6-8 weeks. Temporary treatment with a beta blocker may be sufficient.
Subject(s)
Antibodies, Monoclonal/adverse effects , Antineoplastic Agents/adverse effects , Hypothyroidism/chemically induced , Lung Neoplasms/drug therapy , Thyrotoxicosis/chemically induced , Aged , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Squamous Cell/drug therapy , Female , Humans , Middle Aged , NivolumabSubject(s)
Humans , Algorithms , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Carcinoma, Non-Small-Cell LungABSTRACT
Introducción: CCB es una nueva fluoropirimidina que suma a las ventajas de la vía oral, su aceptable toxicidad y actividad, con bajo perfil costo-beneficio para el tratamiento paliativo del cáncer de mama. Objetivos: analizar nuestra experiencia en forma retrospectiva en relación a la utilización de CCB, en pacientes con cáncer de mama metastásico. Determinar su eficacia y perfil de toxicidad administrado por vía oral en régimen intermitente. Materiales y métodos: se evaluaron las historias clínicas de 67 pacientes (pts.), con diagnóstico de cáncer de mama metastásico que recibieron tratamiento con CCB, entre julio de 1999 y marzo de 2002, en el Instituto Alexander Fleming. Características de la población: edad mediana: 58 años (rango 32-79); receptores hormonales (RH) positivos 64,17 por ciento; el intervalo libre de enfermedad desde el diagnóstico a la primera manifestación metastásica, (ILE) fue de 115,5 meses (rango 0-231); presentaron patrón metastásico visceral (hepático y pulmonar) 41/67 pts., (61,19 por ciento). La mediana de líneas de tratamiento hormonal previo fue de 2 (rango 0-4) y de quimioterapia 4 (rango 0-7). El 17,91 por ciento de las pts. fueron resistentes a antraciclinas y el 79,10 por ciento, fueron expuestas a taxanos. En 6 pts. se efectuó tratamiento con altas dosis de quimioterapia. Las pacientes fueron tratadas con dosis de 1,5 a 2,5 gramos...(AU)
Subject(s)
Humans , Adult , Female , Middle Aged , Aged , Breast Neoplasms/drug therapy , Fluorouracil/analogs & derivatives , Antimetabolites, Antineoplastic/therapeutic use , Palliative Care , Fluorouracil/therapeutic use , Fluorouracil/adverse effects , Breast Neoplasms , Clinical Trials as Topic , Treatment OutcomeABSTRACT
Introducción: CCB es una nueva fluoropirimidina que suma a las ventajas de la vía oral, su aceptable toxicidad y actividad, con bajo perfil costo-beneficio para el tratamiento paliativo del cáncer de mama. Objetivos: analizar nuestra experiencia en forma retrospectiva en relación a la utilización de CCB, en pacientes con cáncer de mama metastásico. Determinar su eficacia y perfil de toxicidad administrado por vía oral en régimen intermitente. Materiales y métodos: se evaluaron las historias clínicas de 67 pacientes (pts.), con diagnóstico de cáncer de mama metastásico que recibieron tratamiento con CCB, entre julio de 1999 y marzo de 2002, en el Instituto Alexander Fleming. Características de la población: edad mediana: 58 años (rango 32-79); receptores hormonales (RH) positivos 64,17 por ciento; el intervalo libre de enfermedad desde el diagnóstico a la primera manifestación metastásica, (ILE) fue de 115,5 meses (rango 0-231); presentaron patrón metastásico visceral (hepático y pulmonar) 41/67 pts., (61,19 por ciento). La mediana de líneas de tratamiento hormonal previo fue de 2 (rango 0-4) y de quimioterapia 4 (rango 0-7). El 17,91 por ciento de las pts. fueron resistentes a antraciclinas y el 79,10 por ciento, fueron expuestas a taxanos. En 6 pts. se efectuó tratamiento con altas dosis de quimioterapia. Las pacientes fueron tratadas con dosis de 1,5 a 2,5 gramos...
Subject(s)
Humans , Adult , Female , Middle Aged , Antimetabolites, Antineoplastic/therapeutic use , Breast Neoplasms , Fluorouracil , Palliative Care , Breast Neoplasms , Clinical Trials as Topic , Fluorouracil , Treatment OutcomeABSTRACT
The aim of this study was to examine the efficacy and safety of both oxaliplatin as a single agent and oxaliplatin in combination with dailyx5 bolus 5-fluorouracil and folinic acid (5-FU/FA, Mayo clinic regimen) in the first-line treatment of metastatic colorectal cancer (CRC) patients. 73 advanced CRC patients were randomised to receive either oxaliplatin 85 mg/m(2) every 2 weeks (35 patients), or the same treatment combined with 5-FU 425 mg/m(2)/day and FA 20 mg/m(2)/dayx5 days every 4 weeks (38 patients). Treatment was continued until disease progression or unacceptable toxicity. All patients had documented inoperable disease and no previous chemotherapy for advanced disease. Based on the investigators' assessment of best response, objective response rate was 9% (95% confidence interval (CI) 2-24%) in the oxaliplatin arm, and 45% (95% CI 27-64%) in the oxaliplatin+5-FU/FA arm. Median progression-free survival (PFS) was 2 months (95% CI 1.7-2.4 months) in the oxaliplatin arm and 3.9 months (95% CI 2.9-5 months) in the oxaliplatin+5-FU/FA arm. Severe neutropenia was seen in 23% of patients in the oxaliplatin+5-FU/FA arm, and none in the oxaliplatin arm. There were two treatment-related deaths, both in the oxaliplatin+5-FU/FA arm. In the oxaliplatin+5-FU/FA arm, severe diarrhoea, vomiting and stomatitis were seen in 34, 14 and 14% of the patients, respectively. In conclusion, oxaliplatin at a dose of 85 mg/m(2) given every 2 weeks was well tolerated and has limited activity in metastatic CRC, while the combination of this treatment with the full-dose Mayo clinic regimen (5-FU bolus 425 mg/m(2)/day+FA 20 mg/m(2)/dayx5 days every 4 weeks), although active, was unfeasible due to a high level of myelosuppression and gastrointestinal toxicity. Alternative lower dosing or other regimens are to be explored to ascertain the value of bolus 5-FU/FA combined with oxaliplatin.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colonic Neoplasms/pathology , Neoplasm Metastasis/drug therapy , Rectal Neoplasms/pathology , Adult , Aged , Disease-Free Survival , Female , Fluorouracil/administration & dosage , Follow-Up Studies , Humans , Leucovorin/administration & dosage , Liver Neoplasms/secondary , Lung Neoplasms/secondary , Male , Middle Aged , Organoplatinum Compounds/administration & dosage , Oxaliplatin , Treatment OutcomeABSTRACT
The activity and mild toxicity profile of single-agent gemcitabine therapy in untreated (chemonaive) patients with non-small-cell lung cancer (NSCLC) is well documented. This phase II trial was conducted to determine the objective tumour response rate and toxicity profile of single-agent gemcitabine in pretreated patients with NSCLC. Patients with histological evidence of advanced NCSLC stage IIIB or IV; at least one prior chemotherapy regimen including a platinum or taxane analogue; an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2; clinically measurable disease; adequate bone marrow reserve; and adequate renal function; received 1000 mg m(-2) gemcitabine administered over 30 min on days 1, 8 and 15 of a 28-day cycle defined as 3 weekly treatments followed by 1 week of rest. Twenty-nine patients were evaluated for efficacy and 32 for toxicity. One patient achieved a complete response and five patients had a partial response resulting in a total response rate of 20.6% (95% confidence interval (CI) 6-34). Median response duration was 7 months (range 4-11 months). Twelve (41%) patients reached stable disease after two cycles of therapy and 11 (38%) patients had disease progression. Median progression-free survival time was 3 months and median overall survival time was 5.5 months. Toxicity was generally mild (grades 0-2). Severe (grade 3 or 4) haematological toxicities included grade 3 anaemia in one patient and grade 3 thrombocytopenia in two patients. Severe non-haematological toxicities included one patient each with grade 3 liver transaminase elevations, nausea/vomiting and diarrhoea. This study confirms the activity and safety of single-agent gemcitabine in pretreated patients with advanced NSCLC who are refractory or sensitive to first-line therapy.
