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Houston, TX, United States

Amato R.J.,University of Texas Health Science Center at Houston | Amato R.J.,Memorial Hermann Cancer Center | Saxena S.,University of Texas Health Science Center at Houston | Stepankiw M.,University of Texas Health Science Center at Houston
Cancer Investigation

Introduction: This study evaluated objective response and safety for the combination of granulocyte macrophage-colony stimulating factor (GM-CSF), ketoconazole, and mitoxantrone in castration-resistant prostate cancer (CRPC) patients who previously failed docetaxel-based chemotherapy. Methods: Treatment consisted of 400 mg TID ketoconazole, 12 mg/m2 mitoxantrone every 3 weeks, and 250 μg/m2 GM-CSF. Results: Twenty-nine patients were evaluable for response. Median overall survival (OS) for all patients was 18.03 months. Patients with a higher PSA decrease experienced an increased OS and progression-free survival (PFS). Conclusion: This combination demonstrated significant antitumor activity with reversible toxicity in CRPC patients who previously failed docetaxel-based therapy. © 2013 Informa Healthcare USA, Inc. Source

Herrington J.D.,Scott and White Memorial Hospital | Dinh B.C.,Memorial Hermann Cancer Center
Journal of Oncology Pharmacy Practice

Purpose: Rasburicase is a recombinant urate oxidase enzyme administered to high risk patients or to those with preexisting hyperuricemia from tumor lysis syndrome (TLS). The objective of this retrospective review is to evaluate and characterize the use of fixed, low-dose rasburicase for the treatment of hyperuricemia in adult patients. Patients/Methods: A retrospective chart review from 1 October 2005 to 31 December 2011 was conducted in adult oncology patients who received fixed, low-dose rasburicase. Patients who met the inclusion criteria were evaluated for the uric acid level change from baseline and the achievement of uric acid level less than 8 mg/dL. Results: Forty-five patients were included in the analysis in which 26 (58%) patients received 3mg rasburicase. For the 39 patients with baseline uric acid levels 8 mg/dL or higher, 80% achieved a uric acid level lower than 8 mg/dL with a single rasburicase dose. Six patients (13%) required renal replacement therapy despite rasburicase. The median uric acid level reduction 24 h post rasburicase dose 1.5 mg, 3 mg, 4.5 mg, and 6mg were 5.5, 5.8, 3.8, and 10.05 mg/dL, respectively. There was no clinical difference between obese and non-obese patients in terms of their median uric acid reduction, 5.5 vs. 7 mg/dL, respectively. Conclusion: Fixed, low dose rasburicase produced a consistent lowering of uric acid levels and may be utilized in the management of hyperuricemia in TLS. Further study is necessary to determine if a larger fixed dose would be required in those patients with a higher baseline uric acid level. © The Author(s) 2014. Source

Amato R.J.,Memorial Hermann Cancer Center
Drugs of the Future

IMA-901 is a novel, peptide-based therapeutic cancer vaccine consisting of 10 synthetic tumor-associated peptides, which have been identified by isolating heteroduplex mobility assay (HMA)-peptide complexes from primary human renal cell carcinoma (RCC) specimens and determining the peptide sequences by mass spectrometry. IMA-901 consists of nine HMA class I and one HMA class II binding peptides that can activate cytotoxic T cells and T helper (Th) cells. A phase I trial resulted in antitumor activity, especially in those patients found to have multiple T-cell responses. A phase II trial evaluating IMA-901 alone versus IMA-901 and cyclophosphamide found that patients who received the vaccine in combination with cyclophosphamide received significantly greater clinical benefit. All vaccine-related adverse events were mild to moderate and reversible. A phase III trial currently under way seeks to evaluate IMA-901 plus granulocyte-macrophage-colony-stimulating factor with a single low-dose infusion of cyclophosphamide in patients receiving sunitinib as first-line therapy for metastatic RCC. The multipeptide vaccine IMA-901 offers significant promise in the treatment of RCC, especially in combination with molecular-targeted agents. Copyright © 2012 Prous Science, S.A.U. or its licensors. All rights reserved. Source

Ansari M.,University of Houston | Ansari M.,Memorial Hermann Cancer Center | Guo S.,University of Houston | Guo S.,Memorial Hermann Cancer Center | And 9 more authors.
Annals of Clinical and Laboratory Science

Sinonasal undifferentiated carcinoma (SNUC) is a rare and highly malignant tumor that occurs in the nasal cavity and/or paranasal sinuses. Prognosis is poor despite multimodality treatment. Currently, there is no optimal standard of treatment, partially due to a lack of research defining the biology of such tumors. This report discusses two SNUC cases where patients received a novel chemotherapeutic approach using cisplatin, etoposide, Adriamycin (doxorubicin), metformin, and adjuvant melatonin therapies based on morphoproteomic-guidance, followed by consolidation with chemoradiation therapy. This resulted in excellent and objective tomographic and magnetic resonance imaging and clinical responses including complete responses in the induction phase utilizing morphoproteomic-guided therapies. Later, endoscopic excision of the tumor bed failed to reveal any residual tumor. Morphoproteomics helped to define the biology of these SNUC tumors and provided targets for the agents employed, creating a new treatment paradigm for such tumors. This treatment regimen poses a new effective regimen to treat SNUC. © 2013 by the Association of Clinical Scientists, Inc. Source

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