Cancer Clinic

Iloilo, Philippines

Cancer Clinic

Iloilo, Philippines
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Noguchi S.,Osaka University | Kim H.J.,Asan Medical Center | Jesena A.,Cancer Clinic | Parmar V.,Tata Group | And 7 more authors.
Breast Cancer | Year: 2015

Background: Monthly goserelin 3.6 mg dosing suppresses estradiol (E2) production and has proven efficacy in pre-menopausal women with estrogen receptor (ER)-positive breast cancer. This non-inferiority study evaluated the efficacy and safety of 3-monthly goserelin 10.8 mg compared with monthly goserelin 3.6 mg. Methods: This was a Phase 3, open-label, multicenter trial. Pre-menopausal women with ER-positive advanced breast cancer were randomized to 3-monthly goserelin 10.8 mg or monthly goserelin 3.6 mg; all patients received concomitant tamoxifen (20 mg daily). The primary endpoint was progression-free survival (PFS) rate at 24 weeks; non-inferiority was to be confirmed if the entire 95 % confidence interval (CI) for the treatment difference was above −17.5 %. Secondary endpoints included objective response rate (ORR), serum E2 levels, safety, and tolerability. Results: In total, 222 patients were randomized (goserelin 10.8 mg, n = 109; goserelin 3.6 mg, n = 113). PFS rate at week 24 was 61.5 % (goserelin 10.8 mg) and 60.2 % (goserelin 3.6 mg); treatment difference (95 % CI) was 1.3 % (−11.4, 13.9), confirming non-inferiority of goserelin 10.8 mg compared with goserelin 3.6 mg. ORR was 23.9 % (goserelin 10.8 mg) and 26.9 % (goserelin 3.6 mg); treatment difference (95 % CI) was −3.0 % (−15.5, 9.7). At week 24, mean serum E2 concentrations were similar in the goserelin 10.8 mg and goserelin 3.6 mg groups (20.3 pg/mL and 24.8 pg/mL, respectively). Conclusion: A regimen of 3-monthly goserelin 10.8 mg demonstrated non-inferiority compared with monthly goserelin 3.6 mg for PFS rate at 24 weeks, with similar pharmacodynamic and safety profiles, in pre-menopausal women with ER-positive breast cancer. © 2015 The Author(s)


Lee A.Y.Y.,University of British Columbia | Lee A.Y.Y.,British Columbia Cancer Agency | Kamphuisen P.W.,University of Groningen | Meyer G.,University of Paris Descartes | And 161 more authors.
JAMA - Journal of the American Medical Association | Year: 2015

Importance: Low-molecular-weight heparin is recommended over warfarin for the treatment of acute venous thromboembolism (VTE) in patients with active cancer largely based on results of a single, large trial. Objective: To study the efficacy and safety of tinzaparin vs warfarin for treatment of acute, symptomatic VTE in patients with active cancer. Design, Settings, and Participants: A randomized, open-label study with blinded central adjudication of study outcomes enrolled patients in 164 centers in Asia, Africa, Europe, and North, Central, and South America between August 2010and November 2013. Adult patients with active cancer (defined as histologic diagnosis of cancer and receiving anticancer therapy or diagnosed with, or received such therapy, within the previous 6 months) and objectively documented proximal deep vein thrombosis (DVT) or pulmonary embolism, with a life expectancy greater than 6 months and without contraindications for anticoagulation, were followed up for 180 days and for 30days after the last study medication dose for collection of safety data. Interventions: Tinzaparin (175 IU/kg) once daily for 6 months vs conventional therapy with tinzaparin (175 IU/kg) once daily for 5 to 10 days followed bywarfarin at a dose adjusted to maintain the international normalized ratio within the therapeutic range (2.0-3.0) for 6 months. Main Outcomes and Measures: Primary efficacy outcomewas a composite of centrally adjudicated recurrent DVT, fatal or nonfatal pulmonary embolism, and incidental VTE. Safety outcomes included major bleeding, clinically relevant nonmajor bleeding, and overall mortality. Results: Nine hundred patients were randomized and included in intention-to-treat efficacy and safety analyses. Recurrent VTE occurred in 31 of 449 patients treated with tinzaparin and 45 of 451 patients treated with warfarin (6-month cumulative incidence, 7.2% for tinzaparin vs 10.5% for warfarin; hazard ratio [HR], 0.65 [95% CI, 0.41-1.03]; P = .07). There were no differences in major bleeding (12 patients for tinzaparin vs 11 patients for warfarin; HR, 0.89 [95% CI, 0.40-1.99]; P = .77) or overall mortality (150 patients for tinzaparin vs 138 patients for warfarin; HR, 1.08 [95% CI, 0.85-1.36]; P = .54). A significant reduction in clinically relevant nonmajor bleeding was observed with tinzaparin (49 of 449 patients for tinzaparin vs 69 of 451 patients for warfarin; HR, 0.58 [95% CI, 0.40-0.84]; P = .004). Conclusions and Relevance: Among patients with active cancer and acute symptomatic VTE, the use of full-dose tinzaparin (175 IU/kg) daily compared with warfarin for 6 months did not significantly reduce the composite measure of recurrent VTE and was not associated with reductions in overall mortality or major bleeding, but was associated with a lower rate of clinically relevant nonmajor bleeding. Further studies are needed to assess whether the efficacy outcomes would be different in patients at higher risk of recurrent VTE. Copyright © 2015 American Medical Association. All rights reserved.


PubMed | Rajavithi Hospital, Niigata Cancer Center Hospital, China Medical University at Taichung, Osaka University and 6 more.
Type: Journal Article | Journal: Breast cancer (Tokyo, Japan) | Year: 2016

Monthly goserelin 3.6mg dosing suppresses estradiol (E2) production and has proven efficacy in pre-menopausal women with estrogen receptor (ER)-positive breast cancer. This non-inferiority study evaluated the efficacy and safety of 3-monthly goserelin 10.8mg compared with monthly goserelin 3.6mg.This was a Phase 3, open-label, multicenter trial. Pre-menopausal women with ER-positive advanced breast cancer were randomized to 3-monthly goserelin 10.8mg or monthly goserelin 3.6mg; all patients received concomitant tamoxifen (20mg daily). The primary endpoint was progression-free survival (PFS) rate at 24weeks; non-inferiority was to be confirmed if the entire 95% confidence interval (CI) for the treatment difference was above -17.5%. Secondary endpoints included objective response rate (ORR), serum E2 levels, safety, and tolerability.In total, 222 patients were randomized (goserelin 10.8mg, n=109; goserelin 3.6mg, n=113). PFS rate at week 24 was 61.5% (goserelin 10.8mg) and 60.2% (goserelin 3.6mg); treatment difference (95% CI) was 1.3% (-11.4, 13.9), confirming non-inferiority of goserelin 10.8mg compared with goserelin 3.6mg. ORR was 23.9% (goserelin 10.8mg) and 26.9% (goserelin 3.6mg); treatment difference (95% CI) was -3.0% (-15.5, 9.7). At week 24, mean serum E2 concentrations were similar in the goserelin 10.8mg and goserelin 3.6mg groups (20.3pg/mL and 24.8pg/mL, respectively).A regimen of 3-monthly goserelin 10.8mg demonstrated non-inferiority compared with monthly goserelin 3.6mg for PFS rate at 24weeks, with similar pharmacodynamic and safety profiles, in pre-menopausal women with ER-positive breast cancer.


Jain M.M.,Hospital and Research Center | Gupte S.U.,Cancer Clinic | Patil S.G.,HCG Bangalore Institute of Oncology | Pathak A.B.,Cancer Care Clinic | And 18 more authors.
Breast Cancer Research and Treatment | Year: 2016

Paclitaxel is widely used in the treatment of patients with metastatic breast cancer (MBC). Formulations of paclitaxel contain surfactants and solvents or albumin derived from human blood. The use of co-solvents such as polyoxyethylated castor oil is thought to contribute to toxicity profile and hypersensitivity reactions as well as leaching of plasticizers from polyvinyl chloride bags and infusion sets. Currently, nab-paclitaxel, an albumin-bound paclitaxel in nanometer range continues to be the preferred taxane formulation used in clinic. This study (CTRI/2010/091/001116) investigated the efficacy and tolerability of a polyoxyethylated castor oil- and albumin-free formulation of paclitaxel [paclitaxel injection concentrate for nanodispersion (PICN)] compared with nab-paclitaxel in women with refractory MBC. The current study was a multicenter, open-label, parallel-group, randomized, comparative phase II/III trial evaluating the efficacy and safety of PICN (260 mg/m2 [n = 64] and 295 mg/m2 [n = 58] every 3 weeks) compared with nab-paclitaxel (260 mg/m2 every 3 weeks [n = 58]) in women 18 and 70 years old with confirmed MBC. Overall response rate (ORR) was assessed with imaging every 2 cycles. An independent analysis of radiologic data was performed for evaluable patients. Progression-free survival (PFS) was a secondary efficacy measure. Independent radiologist-assessed ORRs in the evaluable population of women aged ≥70 years were 35, 49, and 43 % in the PICN 260 mg/m2, PICN 295 mg/m2, and nab-paclitaxel 260 mg/m2 arms, respectively. Median PFS in the evaluable population was 23, 35, and 34 weeks in the PICN 260 mg/m2, PICN 295 mg/m2, and nab-paclitaxel 260 mg/m2 arms, respectively. Adverse events occurred in similar proportions of patients across treatment arms. Hypersensitivity reactions were not frequently observed with the clinical use of PICN across the treatment cohorts. In women with metastatic breast cancer, PICN at 260 and 295 mg/m2 every 3 weeks was effective and well tolerated and showed similar tolerability compared with nab-paclitaxel 260 mg/m2 every 3 weeks. Statistically, significant differences were not observed in the PICN and nab-paclitaxel treatment arms for radiologist-assessed ORR or median PFS. The novel paclitaxel formulation, PICN, offers apart from efficacy, potential safety advantage of decreased use of corticosteroid pretreatment and the absence of the risk of transmission of blood product-borne disease. © 2016, The Author(s).


PubMed | Nizam's Institute of Medical Sciences, Vedanta Institute of Medical science, Orchid Nursing Home, Medicity and 15 more.
Type: Clinical Trial, Phase II | Journal: Breast cancer research and treatment | Year: 2016

Paclitaxel is widely used in the treatment of patients with metastatic breast cancer (MBC). Formulations of paclitaxel contain surfactants and solvents or albumin derived from human blood. The use of co-solvents such as polyoxyethylated castor oil is thought to contribute to toxicity profile and hypersensitivity reactions as well as leaching of plasticizers from polyvinyl chloride bags and infusion sets. Currently, nab-paclitaxel, an albumin-bound paclitaxel in nanometer range continues to be the preferred taxane formulation used in clinic. This study (CTRI/2010/091/001116) investigated the efficacy and tolerability of a polyoxyethylated castor oil- and albumin-free formulation of paclitaxel [paclitaxel injection concentrate for nanodispersion (PICN)] compared with nab-paclitaxel in women with refractory MBC. The current study was a multicenter, open-label, parallel-group, randomized, comparative phase II/III trial evaluating the efficacy and safety of PICN (260 mg/m(2) [n = 64] and 295 mg/m(2) [n = 58] every 3 weeks) compared with nab-paclitaxel (260 mg/m(2) every 3 weeks [n = 58]) in women 18 and 70 years old with confirmed MBC. Overall response rate (ORR) was assessed with imaging every 2 cycles. An independent analysis of radiologic data was performed for evaluable patients. Progression-free survival (PFS) was a secondary efficacy measure. Independent radiologist-assessed ORRs in the evaluable population of women aged 70 years were 35, 49, and 43 % in the PICN 260 mg/m(2), PICN 295 mg/m(2), and nab-paclitaxel 260 mg/m(2) arms, respectively. Median PFS in the evaluable population was 23, 35, and 34 weeks in the PICN 260 mg/m(2), PICN 295 mg/m(2), and nab-paclitaxel 260 mg/m(2) arms, respectively. Adverse events occurred in similar proportions of patients across treatment arms. Hypersensitivity reactions were not frequently observed with the clinical use of PICN across the treatment cohorts. In women with metastatic breast cancer, PICN at 260 and 295 mg/m(2) every 3 weeks was effective and well tolerated and showed similar tolerability compared with nab-paclitaxel 260 mg/m(2) every 3 weeks. Statistically, significant differences were not observed in the PICN and nab-paclitaxel treatment arms for radiologist-assessed ORR or median PFS. The novel paclitaxel formulation, PICN, offers apart from efficacy, potential safety advantage of decreased use of corticosteroid pretreatment and the absence of the risk of transmission of blood product-borne disease.


NEW YORK, NY, November 03, 2016-- The Nevada Mesothelioma Victims Center is now offering a Veteran or a skilled trades worker such as a plumber or electrician with confirmed mesothelioma in Nevada a vital service to make certain they hire the nation's most skilled, qualified, and experienced attorneys to assist them with their potential compensation.What most people with mesothelioma do not realize is the nation's the nation's most elite lawyers who do nothing but mesothelioma will not only want to talk to them about the compensation-in most instances they will also want to personally handle the compensation claim and take a leadership role in getting better compensation for their client. For more information, a diagnosed person in Nevada or their family members are urged to contact the Nevada Mesothelioma Victims Center anytime at 800-714-0303. http://Nevada.MesotheliomaVictimsCenter.Com The Center says, "We do not want a US Navy Veteran, a construction worker, an electrician or a plumber in Nevada with mesothelioma to gamble on their compensation if they have been diagnosed with cancer caused by asbestos exposure. Mesothelioma is an incredibly rare-about 2500 US citizens will be diagnosed this year and because so much asbestos was used in the Nevada probably dozens of people will be diagnosed this year in Nevada."As we would like to explain anytime to a diagnosed person in Nevada or their family members if they call us anytime at 800-714-0303-if the most capable mesothelioma attorneys in the nation will do your compensation claim-why settle for a local car accident lawyer? The difference could be hundreds of thousands of dollars in additional compensation-or like we enjoy saying-'like 10 brand new F-150 fully equipped Ford pickup trucks. Why settle for less?" http://Nevada.MesotheliomaVictimsCenter.Com At the same time the Center is incredibly passionate about making certain a US Navy Veteran should be seen by physicians who have experience dealing with the treatment of mesothelioma. In the instance of Nevada some of the best possible treatment facilities may be in California or Utah, as the Center would like to explain:* Comprehensive Cancer Clinic Las Vegas, Nevada: http://www.cccnevada.com/ * UCLA Medical Center Los Angeles, California: https://www.uclahealth.org/reagan/Pages/default.aspx * The Huntsman Cancer Institute Salt Lake City, Utah: http://healthcare.utah.edu/huntsmancancerinstitute/ "If the diagnosed US Navy Veteran lives in Nevada, we are strongly encouraging them or their family to reach out to the Huntsman Cancer Institute in Salt Lake City and/or the UCLA Medical Center in Los Angeles. In both instances world class treatment is offered." http://Nevada.MesotheliomaVictimsCenter.Com High-risk work groups for exposure to asbestos in Nevada include Veterans of the US Navy, former power plant workers, shipyard workers, oil refinery workers, steel mill workers, miners, factory workers, miners, plumbers, electricians, auto mechanics, machinists, and construction workers. Typically, the exposure to asbestos occurred in the 1950's, 1960's, 1970's, or 1980's, and typically the exposure to asbestos did not occur in Nevada.The Nevada Mesothelioma Victims Center wants to emphasize their unsurpassed services for a diagnosed victim are available statewide anywhere in Nevada including communities such as Las Vegas, Reno, Carson City, Henderson, Paradise, and Enterprise.The states indicated with the highest incidence of mesothelioma include Maine, Massachusetts, Connecticut, Maryland, New Jersey, Pennsylvania, Ohio, West Virginia, Virginia, Michigan, Illinois, Minnesota, Louisiana, Washington, and Oregon. However, mesothelioma can happen in Nevada, as the Center would like to explain anytime at 800-714-0303.For more information about mesothelioma please refer to the National Institutes of Health's web site related to this rare form of cancer: http://www.nlm.nih.gov/medlineplus/mesothelioma.html


Thisoda P.,Siriraj Hospital | Ketsa-ard K.,Siriraj Hospital | Thongprasert S.,Cancer Clinic | Vongsakul M.,Mahidol University | And 3 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2013

The study aimed to evaluate immune-stimulating effects of a well-known Thai folkloric remedy when used for adjuvant therapy with conventional chemotherapeutics for treatment of breast cancer. Immunostimulating influence of the remedy (215 mg/kg body weight per day) on NK cell activity and TNF-α release from the monocytes/macrophages were investigated in a total of 15 healthy women and 13 female patients with breast cancer (Group 1). The effect of breast tumor surgery on NK cell activity was further investigated in 18 female patients with breast cancer (Group 2). NK cell cytotoxic activity was determined by chromium release cytotoxic assay using K562, an erythroleukemic cell line. TNF-α release from monocytes/macrophages separated from blood samples was determined through a biological assay using actinomycin D-treated L929 mouse fibroblast cells in the presence and absence of LPS. Baseline NK cell activity of the monocytes/macrophages separated from Group 2 patients expressed as %cytotoxicity was significantly lower than in the healthy subjects at E:T ratios of 100:1 and 25:1. In healthy subjects, there was no change in NK cell cytotoxic activity (%cytotoxicity or LU) following 1 and 2 weeks of treatment with the remedy compared with the baseline at various E:T ratios but the binding activity (%binding) was significantly increased after 2 weeks of treatment. The addition of one or two conventional chemotherapeutic regimens did not significantly reduce the NK cytotoxic activity but did affect release of TNF-a in both unstimulated and LPS-stimulated samples. Surgery produced a significant suppressive effect on NK cell activity. The use of the remedy as an adjunct therapy may improve therapeutic efficacy and safety profiles of conventional chemotherapeutic regimens through stimulation of the immune system in cancer patients.

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