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Szczecin, Poland

Lynch T.J.,Yale Cancer Center | Bondarenko I.,City Clinical Hospital | Luft A.,Leningrad Regional Clinical Hospital | Serwatowski P.,Oddzial Chemioterapii | And 7 more authors.
Journal of Clinical Oncology | Year: 2012

Purpose: Ipilimumab, which is an anti-cytotoxic T-cell lymphocyte-4 monoclonal antibody, showed a survival benefit in melanoma with adverse events (AEs) managed by protocol-defined guidelines. A phase II study in lung cancer assessed the activity of ipilimumab plus paclitaxel and carboplatin. Patients and Methods: Patients (N = 204) with chemotherapy-naive non-small-cell lung cancer (NSCLC) were randomly assigned 1:1:1 to receive paclitaxel (175 mg/m 2) and carboplatin (area under the curve, 6) with either placebo (control) or ipilimumab in one of the following two regimens: concurrent ipilimumab (four doses of ipilimumab plus paclitaxel and carboplatin followed by two doses of placebo plus paclitaxel and carboplatin) or phased ipilimumab (two doses of placebo plus paclitaxel and carboplatin followed by four doses of ipilimumab plus paclitaxel and carboplatin).Treatment was administered intravenously every 3 weeks for ≥ 18 weeks (induction). Eligible patients continued ipilimumab or placebo every 12 weeks as maintenance therapy. Response was assessed by using immune-related response criteria and modified WHO criteria. The primary end point was immune-related progression-free survival (irPFS). Other end points were progression-free survival (PFS), best overall response rate (BORR), immune-related BORR (irBORR), overall survival (OS), and safety. Results: The study met its primary end point of improved irPFS for phased ipilimumab versus the control (hazard ratio [HR], 0.72; P = .05), but not for concurrent ipilimumab (HR, 0.81; P = .13). Phased ipilimumab also improved PFS according to modified WHO criteria (HR, 0.69; P = .02). Phased ipilimumab, concurrent ipilimumab, and control treatments were associated with a median irPFS of 5.7, 5.5, and 4.6 months, respectively, a median PFS of 5.1, 4.1, and 4.2 months, respectively, an irBORR of 32%, 21% and 18%, respectively, a BORR of 32%, 21% and 14%, respectively, and a median OS of 12.2, 9.7, and 8.3 months. Overall rates of grade 3 and 4 immune-related AEs were 15%, 20%, and 6% for phased ipilimumab, concurrent ipilimumab, and the control, respectively. Two patients (concurrent, one patient; control, one patient) died from treatment-related toxicity. Conclusion: Phased ipilimumab plus paclitaxel and carboplatin improved irPFS and PFS, which supports additional investigation of ipilimumab in NSCLC. © 2012 by American Society of Clinical Oncology. Source

Skowronska-Gardas A.,Zaklad Teleradioterapii | Chojnacka M.,Zaklad Teleradioterapii | Pedziwiatr K.,Zaklad Teleradioterapii | Sloniewska A.,Zaklad Teleradioterapii | And 5 more authors.
Nowotwory | Year: 2011

Results. 1, 2 and 3-year overall survival and recurrence free survival rates were 63%, 52%, 39% and 54, 38%, 31%, respectively. Failure was found in 36 patients, only in 4 cases as an isolated local recurrence. The microscopic radicality of the resection and the type of gastrectomy performed had significant influence on overall and progression free survival. Additionally, progression free survival rates were significantly longer in the group at stage I and II versus III and IV acc. to AJCC. Conclusions. 1. Adjuvant chemoradiotherapy of gastric cancer patients appears to be effective, but the failure ratio remains high. 2. Potential toxicity of this treatment can be reduced with 3D conformal radiotherapy. 3. RSR is the independent prognostic factor that could be used in referring patients for studies with more aggressive therapy. Source

Andryszak P.,University Kazimierza Wielkiego | Izdebski P.,University Kazimierza Wielkiego | Tujakowski J.,Oddzial Chemioterapii
Nowotwory | Year: 2012

In recent years attention has been paid to the occurrence of deterioration of cognitive functioning after chemotherapy. The aim of this work is to analyze results of previously conducted studies of the effects of adjuvant chemotherapy on cognitive performance of women treated for breast cancer. We have analyzed the results of 40 neuropsychological studies published to June 2011. Women with breast cancer who were treated with chemotherapy were found to experience some kind of deterioration in attention, memory and language skills. The results indicate that subjectively perceived cognitive deficits are associated with distress accompanying cancer and its treatment. In the majority of studies of cognitive functioning using neuropsychological tests deterioration in attention, processing speed, memory, visuo-spatial functions and language skills has been demonstrated. No correlation has been found between deterioration of cognitive functioning and level of depression and anxiety, fatigue, hormonal status and quality of life. © Polskie Towarzystwo Onkologiczne. Source

Styczynski J.,Nicolaus Copernicus University | Gil L.,University Medyczny | Piatkowska M.,Oddzial Chemioterapii | Wlodarczyk Z.,Szpital Uniwersytecki nr 1 Im. dr Jurasza | Wlodarczyk Z.,Nicolaus Copernicus University
Acta Haematologica Polonica | Year: 2010

EBV disease develops after infection with Epstein-Barr virus (EBV). Clinically it may manifest as various syndromes related to primary (lytic) infection or reactivation (EBV-DNA-emia), previously known as latent infection. Post-transplant lymphoproliferative disorder (PTLD), developing after hematopoietic stem cell (HSCT) or solid organ transplantation (SOT) is the most aggressive form of EBV disease. It usually presents as a tumor or infiltration of lymphocytes B transformed by EBV, caused by lack of control of lymphocytes T. The diagnosis of PTLD can be made at a probable or proven level. Probable PTLD is defined as significant lymphadenopathy (or other endorgan disease) with high EBV blood load, in the absence of other etiologic factors or established diseases. Diagnosis of proven PTLD is made when EBV is detected from an organ by biopsy or other invasive procedures with a test with appropriate sensitivity and specificity together with symptoms and/or signs from the affected organ. Among patients after HSCT following risk factors of PTLD development are recognized: unrelated or HLA-mismatched transplant, cord blood transplant, T-cell depletion in vitro or in vivo, the use of thymoglobulin or anti-CD3 antibodies, serological EBV incompatibility between donor and recipient, splenectomy. PTLD after SOT occurs more often than after HSCT, and risk factors include: younger donor age, multiple organ transplantation, and high intensity of immunosuppressive therapy. This review presents similarities and differences in biology, course and therapy of PTLD after HSCT and SOT. Possibilities of prophylaxis, pre-emptive therapy and therapy of probable or proven PTLD are discussed. Source

Kolacinska A.,Oddzial Chirurgii Onkologicznej | Blasinska-Morawiec M.,Oddzial Chorob Rozrostowych | Dowgier-Witczak I.,Oddzial Chemioterapii | Kordek R.,Zaklad Patomorfologii | Morawiec Z.,Oddzial Chirurgii Onkologicznej
Przeglad Menopauzalny | Year: 2012

Background: An axillary pathological complete response (pCR) after neoadjuvant systemic treatment, used in breast cancer with axillary metastases, is defined as no residual cancer in the axilla reported by the pathologist. Aim: The aim of the study is to correlate the ER, PR, HER2 receptor subtype in breast cancer patients axillary node positive with axillary pCR after neoadjuvant systemic treatment. Material and methods: 97 consecutive breast cancer patients with axillary metastases were enrolled in the study. Axillary lymph node dissection was performed after neoadjuvant systemic treatment. Results: Twenty five out of 97 breast cancer patients with axillary metastases achieved an axillary pCR (fraction 0.26). In triple negative ER(-) PR(-) HER2(-), ER(-) PR(-) HER2(+), ER(+) PR(+) HER2(-) and ER(+) PR(+) HER2(+) breast cancer group, these fractions were 0.48 (17/35), 0.21 (3/14), 0.13 (5/39) and 0 (0/9), respectively. Conclusions: The rate of the axillary pCR is statistically significantly higher in triple negative breast cancer patients in comparison with ER(+) PR(+) HER2(-) tumors (p < 0.002; χ2 = 9.639) and ER(+)PR(+)HER2(+) cancers (p < 0.03; χ2 = 5.222). Identification of these patients with the axillary pCR could result in more axilla conserving therapies. Source

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